• Clinical Denials and Appeals-Clinical Supervisor

    Catholic Health (Buffalo, NY)
    …finance, business management, operational analysis, information systems or related field + Registered Nurse with a four (4) year degree and Unrestricted ... payers) and internal stakeholders including, but not limited to, Utilization Review, Case Management, Clinical Documentation Integrity, Health Information...NYS RN license, preferred + Holds, or will obtain within… more
    Catholic Health (10/01/25)
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  • Case Manager Supervisor

    Stony Brook University (Stony Brook, NY)
    Case Manager Supervisor **Position Summary** At Stony Brook Medicine, a **TH Staff Associate/Supervisor Case Manager ** is a valuable member of our team, who ... of excellence. **Duties of a TH Staff Associate/Supervising Case Manager in the Care Management Department may include the...staff performance including new staff orientation + Knowledge of Utilization Review and LOS + Review of high-risk complex… more
    Stony Brook University (09/16/25)
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  • Nurse Case Manager Per Diem

    Nuvance Health (Rhinebeck, NY)
    …affiliates, Position Summary: Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support ... from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within the assigned… more
    Nuvance Health (09/21/25)
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  • Care Manager

    Catholic Health Services (Smithtown, NY)
    …improve outcomes - to every patient, every time. Job Details CARE MANAGER RESPONSIBILITIES: + Assesses, plans, implements, monitors and evaluates options and ... across the acute care continuum. + Performs required activities for utilization management, PRI assessment and completion, transition planning, and identification of… more
    Catholic Health Services (08/22/25)
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  • Hospice Case Manager , Evenings

    Guthrie (Vestal, NY)
    …Career with a $25K Sign-On Bonus: Join Guthrie Hospice in Vestal, NY as a Full-Time RN Case Manager ! Position Details: + Hours: Typically 2:00 PM - 10:30 PM, ... dignity and wishes of each individual. As a Case Manager with Guthrie Hospice, you will join a team...providing care for Guthrie Hospice. Education, License & Cert: Registered Professional Nurse currently licensed in New… more
    Guthrie (08/26/25)
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  • Administrative Clinical Supervisor

    Ellis Medicine (Schenectady, NY)
    …EDUCATION AND EXPERIENCE REQUIREMENTS: + Currently licensed in New York State as a Registered Nurse and a graduate of an approved school of nursing. + ... + The Administrative Clinical Supervisor will work collaboratively with the DON and Nurse Managers to assure effective and efficient utilization of staff and… more
    Ellis Medicine (09/26/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Latham, NY)
    **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
    Elevance Health (09/11/25)
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  • Behavioral Health Care Manager II

    Elevance Health (New Hyde Park, NY)
    **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers ... granted as required by law. The **Behavioral Health Care Manager II** is responsible for managing psychiatric and substance...equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by… more
    Elevance Health (09/30/25)
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  • Director, Clinical Systems

    Molina Healthcare (Yonkers, NY)
    …skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and ... development, implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical… more
    Molina Healthcare (10/01/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Rochester, NY)
    …skills. + Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** + Registered Nurse ( RN ). The license must be active ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
    Molina Healthcare (09/20/25)
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