• Perioperative Operational Analyst - Full Time…

    Mohawk Valley Health System (Utica, NY)
    …Services. + Familiarizes self with each unit's activities and benchmarks through staffing utilization reports, and dialogues with charge nurse , nurse manager ... + Reviews performance and management indicator reports. + Maintains staff utilization policies and procedures. + Promotes effective communication and teamwork within… more
    Mohawk Valley Health System (11/12/25)
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  • Middle Revenue Cycle Clinical Supervisor

    Catholic Health (Buffalo, NY)
    …Cycle and interdisciplinary care team and works in conjunction with the Utilization Review Manager and Manager Clinical Documentation Integrity. The Middle Revenue ... Cycle - Clinical Supervisor is responsible for training and mentoring Utilization Review, Clinical Documentation Integrity and Clinical Denials and Appeals teams.… more
    Catholic Health (12/31/25)
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  • Medical Director (NV)

    Molina Healthcare (Rochester, NY)
    …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure ... most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-… more
    Molina Healthcare (11/21/25)
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  • Case Mgr, RN- Case Management

    Northwell Health (Staten Island, NY)
    …delays and resolves issues with appropriate departments. + Identifies appropriate utilization of Social Work Services and makes referrals when appropriate. + ... a resource to the health care team regarding quality, utilization of clinical resources, payer, and reimbursement issues. +...+ Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification,… more
    Northwell Health (12/20/25)
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  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …optimal patient outcomes in the expected time frame and with most efficient utilization of resources. Carries out activities related to utilization management, ... base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay reviews and assists with managing the length of… more
    Rochester Regional Health (10/24/25)
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  • Supervisor, Clinical RN -Prep/Recovery Unit - Full…

    Guthrie (Binghamton, NY)
    …Experience: + Two years of recent clinical supervisory experience or charge nurse experience desired Essential Functions: + RESOURCE UTILIZATION ; Considers ... judgment. Ensures compliance with entity/department goals and clinical resource utilization . Promotes change and teamwork. Performs clinical duties of the… more
    Guthrie (12/09/25)
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  • RN Acute Case Manager - System Care Management…

    Guthrie (Binghamton, NY)
    …for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with other internal ... in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case Management certification… more
    Guthrie (11/26/25)
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  • Case Management Supervisor - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision ... direct oversight of the case manager's daily operations of utilization review practice, process and procedures ensuring accurate member...conjunction with HR. + If working as a Registered Nurse , practices in accordance with New York State Practice… more
    Mohawk Valley Health System (11/21/25)
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  • Medical Data Entry Manager

    Constructive Partnerships Unlimited (Brooklyn, NY)
    …POSITION SUMMARY Under the Supervision of the VP of Nursing and Nurse Administrators, works collaboratively and assists in the management of medical care ... scheduling of medical appointments by responsible staff. Monitors and track transportation utilization and convey all information to ensure all staffing needs are… more
    Constructive Partnerships Unlimited (12/21/25)
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  • Clinical Program Manager - Clinical Command Center…

    Mount Sinai Health System (New York, NY)
    …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse , Physician Assistant, or Nurse Practitioner, who manages the 24 ... and supporting patient-centered care. **Qualifications** Must be a Licensed Registered Nurse , Physician Assistant or Nurse Practitioner Registered Nurse more
    Mount Sinai Health System (11/08/25)
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