• Staff Nurse- Case Manager - Mount…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED ... experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum… more
    Mount Sinai Health System (04/16/25)
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  • RN/ Case Manager -MSH- Case…

    Mount Sinai Health System (New York, NY)
    …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager MSH Case ...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
    Mount Sinai Health System (04/15/25)
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  • Case Manager RN- Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** The Case Manager (CM) will be responsible...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
    Mount Sinai Health System (04/22/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …to track, review , and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... issues. To support the mission of Helio Health, theUtilization Case Manager will enhance the program's efforts...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
    Helio Health Inc. (05/02/25)
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  • Registered Nurse Care Manager…

    Catholic Health (Buffalo, NY)
    …Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review , as an active member of the Care Management and ... clinical skills and discharge planning principles, the RN Care Manager , Utilization Review collaborates with...experience + Preferred prior insurance /managed care/ utilization review experience in the role of a Case… more
    Catholic Health (05/01/25)
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  • Trainer - Clinical Services - Utilization…

    Molina Healthcare (Albany, NY)
    …(RN) or State Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), ... Responsible for the development, implementation, and delivery of training curriculum for Utilization Management, Case Management, and LTSS staff. Leads and… more
    Molina Healthcare (05/07/25)
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  • Case Manager - Case…

    Arnot Health (Elmira, NY)
    …to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case ... Job Description MAIN FUNCTION: The Case Manager coordinates, negotiates, procures services... case managers. f. The Case Manager tracks and trends LOS, resource utilization ,… more
    Arnot Health (02/06/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and social ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review , and… more
    Ellis Medicine (04/25/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtain a ... Position Summary: The Acute Case Manager utilizes industry accepted processes...healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and… more
    Guthrie (02/11/25)
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  • Pharmacist, Utilization Mgmt (CA & WA)

    Molina Healthcare (Rochester, NY)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
    Molina Healthcare (05/02/25)
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