• 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)
    …prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification ... ** Utilization Management Representative I** **Virtual:** This role enables...responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing… more
    Elevance Health (08/08/25)
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  • Clinical Review Nurse - Concurrent…

    Centene Corporation (New York, NY)
    …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... health management systems according to utilization management policies and guidelines + Works with healthcare...or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers… more
    Centene Corporation (08/02/25)
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  • Care Review Clinician, Prior Auth (RN) Pega…

    Molina Healthcare (NY)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
    Molina Healthcare (07/12/25)
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  • Quality Review Nurse

    Sedgwick (Albany, NY)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague technical ... related line of business experience in telephonic case management (TCM) and/or utilization review or equivalent combination of education and experience required.… more
    Sedgwick (08/15/25)
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  • Nurse Practitioner-Cardiothoracic- Mount…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Job Title : Nurse Practitioner- Cardiothoracic- Mount Sinai Hospital - Full Time - Night** A nurse practitioner (NP) as described in Title ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
    Mount Sinai Health System (08/03/25)
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  • Registered Nurse I, Acute Care - Emergency…

    Bassett Healthcare (Cobleskill, NY)
    …discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Emergency Department is accountable for the ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for a new nurse more
    Bassett Healthcare (07/16/25)
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  • Nurse Practitioner - Cardiovascular…

    Mount Sinai Health System (New York, NY)
    **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion… more
    Mount Sinai Health System (07/04/25)
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  • Registered Nurse II, Acute Care - Inpatient…

    Bassett Healthcare (Cooperstown, NY)
    …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse II, Acute Care is accountable for the delivery of safe patient care ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to… more
    Bassett Healthcare (08/01/25)
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  • Registered Nurse - Primary Care Mental…

    Veterans Affairs, Veterans Health Administration (Montrose, NY)
    Summary The Primary Care Mental Health Integration Registered Nurse is responsible for all elements of the nursing process when providing and/or supervising direct ... Care Mental Health Integration (PCMHI) Collaborative Care Manager (CoCM) Registered Nurse (RN) is responsible for providing competent, evidence-based care to… more
    Veterans Affairs, Veterans Health Administration (08/09/25)
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