• Discharge Planner

    Ellis Medicine (Schenectady, NY)
    …is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to facilitate patient discharge plans, support coordination of ... care activities, and assist in utilization management activities under the direction of a registered...activities under the direction of a registered nurse and/or social worker. Responsibilities include maintaining case more
    Ellis Medicine (08/28/25)
    - Related Jobs
  • Nurse Case Manager

    Nuvance Health (Carmel, NY)
    …Licensure as RN required; LMSW /LCSW preferred; Case management certification preferred. 2.Work Experience:3 years ... Leadership experience preferred; Utilization review, discharge planning or case management experience preferred. Location: Carmel-PHC 670 Stoneleigh Avenue… more
    Nuvance Health (09/10/25)
    - Related Jobs
  • Registered Nurse - Dermatology…

    Veterans Affairs, Veterans Health Administration (New York, NY)
    …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Administers… more
    Veterans Affairs, Veterans Health Administration (10/01/25)
    - Related Jobs
  • Clinical Denials and Appeals-Clinical Supervisor

    Catholic Health (Buffalo, NY)
    …parties (the payers) and internal stakeholders including, but not limited to, Utilization Review, Case Management , Clinical Documentation Integrity, Health ... , operational analysis, information systems or related field + Registered Nurse with a four (4) year...an Acute Care Hospital Setting + Experience working within Utilization Review or Case Management more
    Catholic Health (10/01/25)
    - Related Jobs
  • RN Utilization Management

    Trinity Health (Albany, NY)
    …often lead to innovative solutions. ** Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** If ... you are looking for an RN position in Case Management ...accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for… more
    Trinity Health (09/30/25)
    - Related Jobs
  • Nurse Educator

    CVS Health (NY)
    …+ 3+ years of experience in a managed care clinical operation environment ( utilization management , case management , and/or behavioral health ... lives in new markets across the country. + The Nurse Educator will support the training and compliance monitoring... case management ) required. + Unrestricted RN licensure required + 1+ year of DSNP/ MMP… more
    CVS Health (10/01/25)
    - Related Jobs
  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …clinical approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant..., utilization review, and payer knowledge. A Case Management certification or obtaining a … more
    Guthrie (08/27/25)
    - Related Jobs
  • Utilization Manager Reviewer, RN

    Excellus BlueCross BlueShield (Rochester, NY)
    …cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as ... depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of… more
    Excellus BlueCross BlueShield (08/23/25)
    - Related Jobs
  • RN Supervisor Case Management

    Mohawk Valley Health System (Utica, NY)
    RN Supervisor Case Management - Full Time - Days Department: CARE MANAGEMENT SERVICES Job Summary The Supervisor Case Management - SNH is ... responsible for the oversight of the case management staff's authorization/coordination/ utilization and...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
    Mohawk Valley Health System (07/09/25)
    - Related Jobs
  • RN Case Manager - Case

    Guthrie (Corning, NY)
    …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...an understanding of the regulatory requirements relative to the case management process. Certified to complete Patient… more
    Guthrie (09/23/25)
    - Related Jobs