• Community Health Assessment Field Nurse

    Excellus BlueCross BlueShield (Rochester, NY)
    …complex assignments, difficult members and highly visible issues. + Understanding of the basic Utilization Management and Case Management aspects of the ... and health care services for members. The SN CHA Nurse may also perform other technical and administrative tasks...and required. + Performs other functions as assigned by management . Minimum Qualifications: + RN with valid… more
    Excellus BlueCross BlueShield (09/27/25)
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  • RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    Provides health care services regarding admissions, case management , discharge planning and utilization review. Responsibilites: Reviews admissions and ... retrospective medical necessity and/or compliance with reimburesement policy criteria. Provides case management and/or consultation for complex cases. Assists… more
    Guthrie (07/05/25)
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  • Case Manager, RN (Commercial)

    Excellus BlueCross BlueShield (Rochester, NY)
    …and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory ... group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational… more
    Excellus BlueCross BlueShield (09/30/25)
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  • RN Case Mgr I-HC

    Rochester Regional Health (Rochester, NY)
    Job Title: RN Case Mgr I - HC STATUS:...as level I, plus: Understands when to escalate to management . Required Qualifications: * Registered Nurse ... Monroe County Sign-On Bonus: Up to 20,000 SUMMARY: The RN Case Manager is responsible for the...minimum of 2 years of home care experience. + Registered Nurse license in New York State.… more
    Rochester Regional Health (09/17/25)
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  • Case Manager RN

    Bassett Healthcare (Oneonta, NY)
    …Current NYS licensure as a Registered Professional Nurse , if applying as a nurse , required + Case Management certification, preferred + Case ... best quality of life possible. What you'll do The Case Manager RN supports the physician and...accurate information to payors. The role integrates and coordinates utilization management , care facilitation, and discharge planning… more
    Bassett Healthcare (09/18/25)
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  • Care Coordinator RN TRI PC Orchard Park

    Catholic Health (West Seneca, NY)
    …experience as a registered nurse required + One (1) year previous case , disease, or utilization management experience preferred + One (1) year ... Science Degree in Nursing required + Current, unrestricted licensure by New York State as a Registered Nurse ( RN ) required EXPERIENCE + Minimum of (1) year… more
    Catholic Health (09/04/25)
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  • RN Case Manager

    Stony Brook University (Stony Brook, NY)
    RN Case Manager **Position Summary** At...high standard of excellence. **Duties of a TH Staff Associate/ Case Manager in the Care Management Department ... Stony Brook Medicine, a **TH Staff Associate/ Case Manager** is a valuable member of our team,...other duties as required. **Qualifications** **Required** : Current NYS RN . A Bachelor's degree or a nurse more
    Stony Brook University (07/16/25)
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  • Utilization Review Nurse

    Independent Health (Buffalo, NY)
    …Degree in Nursing required; Bachelor's degree preferred. Current, active, unrestricted, and licensed registered nurse ( RN ) required. + Two (2) years of ... Collaborative and Accountable. **Essential Accountabilities** Provide High Quality, Professional Utilization Management Services: (Medical necessity review for… more
    Independent Health (09/25/25)
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  • RN OB Case Manager

    Highland Hospital (Rochester, NY)
    RN Care Manager's central role integrates and coordinates access and utilization management , proactive patient management , care facilitation and ... **17006BR** **Title:** RN OB Case Manager **Department/Cost Center:**...nursing experience preferred. Progressive clinical experience; community health, care management , and/or disease management is preferred. Experience… more
    Highland Hospital (09/16/25)
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  • RN Case Manager

    Amergis (Red Hook, NY)
    Salary: $2200 / Week The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization ... and compliance with medical regime. Minimum Requirements: + Current RN licensure in state practicing + At least one...in state practicing + At least one year of Case Management experience preferred + Current CPR… more
    Amergis (09/24/25)
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