• Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for ... determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a professional and… more
    Centene Corporation (08/02/25)
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  • Registered Nurse (RN) - Utilization…

    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) - ... Hospital Description of Duties This position is in the Utilization Review Unit and functions as an assessment ...Utilization Review Unit and functions as an assessment nurse . This is a professional nursing position involving responsibility… more
    Monroe County, NY (08/02/25)
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  • Utilization Management Nurse

    CenterWell (Albany, NY)
    …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
    CenterWell (08/02/25)
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  • Registered Nurse - CLC

    Veterans Affairs, Veterans Health Administration (Syracuse, NY)
    …education, orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities, and ... be referred for consideration as vacancies are available. The Nurse Inpatient Staff Registered Nurse (RN) is...are available. The Nurse Inpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based care… more
    Veterans Affairs, Veterans Health Administration (07/31/25)
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  • Registered Nurse - Med/Surg

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    …education, orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities, and ... EDRP participants ineligible to apply. Responsibilities The Inpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based care to… more
    Veterans Affairs, Veterans Health Administration (06/24/25)
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  • Discharge Planner

    Ellis Medicine (Schenectady, NY)
    …(SW). The Discharge Planner's primary function 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 nurse and/or social… more
    Ellis Medicine (08/28/25)
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  • Registered Nurse 1 Psychiatric (NY Helps),…

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review, P26749 ... NY Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily Utilization… more
    New York State Civil Service (08/14/25)
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  • Asst Utilization Coordinator

    WMCHealth (Valhalla, NY)
    Asst Utilization Coordinator Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing/Nursing Management Department: Clinical Care Management ... Applicant link Job Details: Internal Posting: 08/1/25 to 08/14/25 Assistant Utilization Coordinator Summary: Under general supervision, an incumbent of this class… more
    WMCHealth (08/02/25)
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  • Insurance Specialist-Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
    Mount Sinai Health System (07/23/25)
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  • Utilization Management Representative

    Elevance Health (Latham, NY)
    ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
    Elevance Health (08/26/25)
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