• LPN - Utilization Mgmt…

    Guthrie (Cortland, NY)
    Summary The LPN Utilization Management (UM) Reviewer , in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the ... Packer Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior… more
    Guthrie (10/28/25)
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  • Clinical Reviewer , Nurse -9am -6pm…

    Evolent (Albany, NY)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical /Vocational Nurse with a current, ... Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification...effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary… more
    Evolent (10/21/25)
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  • Care Review Clinician (LVN / LPN )

    Molina Healthcare (Syracuse, NY)
    …Certification, Association Active, unrestricted Utilization Management Certification (CPHM). LVN ( Licensed Vocational Nurse ) or LPN ( Licensed ... state contract, regulation or state board licensing mandates. If licensed , license must be active and unrestricted in state...in ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
    Molina Healthcare (10/22/25)
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  • LPN - Wellness -Strategic Ins Dev - Full…

    Guthrie (Binghamton, NY)
    …leadership and autonomy in nursing practice. + Preferred experience with care management / utilization review , and payer knowledge. + RN considered. ... accredited LPN program Licenses: + The Wellness Nurse must be licensed in both New...The applicant must have a current license as a Practical Nurse in their state of practice… more
    Guthrie (09/26/25)
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  • RN Clinical Review Nurse…

    Centene Corporation (New York, NY)
    …the day after Thanksgiving and Christmas Eve)** **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required Pay Range: $26.50 ... findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and… more
    Centene Corporation (10/24/25)
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  • Quality Management Specialist I

    DePaul (Rochester, NY)
    …+ Performs all other duties as assigned. Qualifications + Registered Nurse or Licensed Practical Nurse with 3 years of experience in long-term care; ... Management Plan within the corporation. + Incident Management - review incident reports and provide...reporting and follow-up consultation and training. + Responsible for Utilization Record Review functions to include Individual… more
    DePaul (10/10/25)
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  • Data Analyst I

    University of Rochester (Rochester, NY)
    …Technician (RHIT) Program **_or_** + Licensure/credentials in clinical specialty such as Registered Nurse , Licensed Practical Nurse , or Emergency Medical ... requests, and external oversight: ie) NYS DOH, ACS Committee on Trauma Registry Management : + Monitor security of data to ensure the integrity and reliability of… more
    University of Rochester (10/28/25)
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  • Practice Administrator OBGYN & GYN

    Crouse Hospital (East Syracuse, NY)
    …+ Desirable Qualifications: + Current NYS Licensure as a Registered Nurse or Licensed Practical Nurse . + Bachelor's degree in Nursing, Health Care ... stability within a fast-growing Medical Practice + Longevity and consistency of management + Tuition reimbursement program + Affiliation with Crouse Hospital Other… more
    Crouse Hospital (09/18/25)
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  • Medical Management Clinician

    Elevance Health (Middletown, NY)
    …or equivalent. + Requires a minimum of 4 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN /LVN ... **Medical Management Clinician** **Location:** **New York** . This role...not require the training or skill of a registered nurse . **Primary duties may include but are not limited… more
    Elevance Health (10/25/25)
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  • Medical Services Coordination Specialist I/II/III

    Excellus BlueCross BlueShield (Rochester, NY)
    …Coordination Specialist provides administrative support for any of the programs of Utilization Management , Behavioral Health, Quality Management , or Member ... and review timeliness, workflow volumes, referrals generated to care management programs + Provides administrative support to the grievance and appeals process… more
    Excellus BlueCross BlueShield (10/21/25)
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