• RN Care Review

    Molina Healthcare (Albany, NY)
    JOB DESCRIPTION **Job Summary** The Care Review Clinician RN provides support for clinical member services review assessment processes. Responsible ... experience. Candidates with MCO experience are highly preferred. The Care Review Clinician must be...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/26/25)
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  • RN Care Review

    Molina Healthcare (Albany, NY)
    JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician

    Molina Healthcare (Buffalo, NY)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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  • Care Review Clinician

    Molina Healthcare (Syracuse, NY)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Rochester, NY)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (10/26/25)
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  • Registered Nurse (T&RC) Surgical…

    Stony Brook University (Stony Brook, NY)
    Registered Nurse (T&RC) Surgical Trauma Intermediate Care Unit Full-Time Night Shift **Position Summary** At Stony Brook Medicine, our Registered Nurses ... while adhering to a medical regimen. **Duties of a Registered Nurse may include the following but...Communicates changes in patient's condition and questions regarding patient care to Charge RN / Clinician . +… more
    Stony Brook University (11/25/25)
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  • Registered Nurse - Medicine Float…

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: Registered Nurse ( RN ) provides professional nursing care to patients within the Department of Medicine. The registered nurse ... Department of Medicine + Screen patients, take vital signs, review medication list, assist clinician with exams,... Nurse level of expertise Minimum Qualifications: NYS licensed/ registered RN . Prior experience in an outpatient… more
    SUNY Upstate Medical University (09/28/25)
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  • Utilization Review Clinician

    Centene Corporation (New York, NY)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... preferred. Experience working with providers and healthcare teams to review care services related to mental health... only: LMSW, LCSW, LMHC, LPC, LMFT, LMHP or RN required Pay Range: $26.50 - $47.59 per hour… more
    Centene Corporation (11/08/25)
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  • Payment Integrity Clinician

    Highmark Health (Albany, NY)
    …of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes… more
    Highmark Health (11/14/25)
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  • Denials Prevention Specialist, Clinician

    Datavant (Albany, NY)
    …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
    Datavant (11/12/25)
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