• RN , Manager , Utilization

    Humana (Albany, NY)
    …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management Leader) utilizes clinical… more
    Humana (09/28/25)
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  • Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... payors for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required.… more
    Catholic Health Services (07/24/25)
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  • Utilization Manager Reviewer,…

    Excellus BlueCross BlueShield (Rochester, NY)
    …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of clinical… more
    Excellus BlueCross BlueShield (08/23/25)
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  • Clinical Learning Facilitator - Utilization

    Molina Healthcare (Buffalo, NY)
    RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in ... board licensing mandate. + At least 2 years in case, disease or utilization management; managed care; or medical/behavioral health settings. + One year of training… more
    Molina Healthcare (09/17/25)
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  • Registered Nurse ( RN )…

    Monroe County, NY (Rochester, NY)
    Full Jobs List Full Exams List Registered Nurse ( RN ) - Utilization Review Unit, Per Diem Location: Rochester, NY Title: Registered Nurse ( RN ) ... to, and works under the general supervision of a Nurse Manager , or other higher-level staff member....Qualifications Possession of a New York State License as a Registered Nurse . Download/View Full Announcement Apply… more
    Monroe County, NY (08/02/25)
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  • Registered Nurse ( RN ) Care…

    Whitney Young Health Center (Albany, NY)
    Registered Nurse ( RN ) Care Manager - Women's Health/Pediatrics (Req 100987) Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) ... Using principles of Patient Centered Medical Home (PCMH), the Care Manager ( RN ) will demonstrate professional nursing practice, excellent communication… more
    Whitney Young Health Center (08/16/25)
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  • Care Manager ( Registered

    Catholic Health Services (Port Jefferson, NY)
    … position who are enrolled in a BSN program may apply + Licensure: New York Registered Nurse ( RN ) License & Registration + Certification: Basic Life Support ... delivery of high quality care. Job Details Our Care Manager ( RN ) will: + Assess, plan, implement,...care clinical RN experience required + Prior RN experience in Utilization Management, Performance Improvement,… more
    Catholic Health Services (09/29/25)
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  • Registered Nurse ( RN )…

    Glens Falls Hospital (Glens Falls, NY)
    …week, can be found*here*. **Job:** **Nursing - Case Management* **Title:** * Registered Nurse ( RN ) - Care Manager (GFMG) (Flexible Scheduling Options for ... *The Impact You Can Make* *Team Impact* The Care Manager will be assigned to manage their own patient...work closely with the Interdisciplinary Team to ensure appropriate utilization and provision of resources for patients including referrals… more
    Glens Falls Hospital (08/08/25)
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  • Registered Nurse Case Manager

    Northwell Health (Staten Island, NY)
    **Req Number** 167724 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... 2 years relevant experience, required. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized… more
    Northwell Health (09/17/25)
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  • Clinical Manager Registered

    Fresenius Medical Center (New York, NY)
    …closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager , the Medical Director, and ... of the appropriate company CQI tools. + Works with the Clinical Coordinator /Charge RN or Nurse Supervisor and Medical Director to implement FMS quality goals… more
    Fresenius Medical Center (09/12/25)
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