• Registered Nurse 1 Psychiatric (NY…

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , ... York State NY Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily … more
    New York State Civil Service (08/14/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
    Centene Corporation (08/02/25)
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  • RN Utilization Review…

    Guthrie (Binghamton, NY)
    …health care services regarding admissions, case management, discharge planning and utilization review . Responsibilites: Reviews admissions and service requests ... planning needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and coordinates compliance to… more
    Guthrie (07/05/25)
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  • Care Review Clinician, Prior Auth…

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

    City of New York (New York, NY)
    …required; make professional recommendations accordingly. - Keep abreast of medical and utilization review techniques and developments relative to the nursing ... Nurse in the Bureau of Medical and Professional Review (BMPR) of Home Care Services Program. As the...- 50935 Qualifications 1. A valid New York State Registered Nurse License and completion of one… more
    City of New York (08/30/25)
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  • RN /Case Manager-MSH-Case…

    Mount Sinai Health System (New York, NY)
    …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager ... a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...System is one of the largest academic medical systems in the New York metro area, with more… more
    Mount Sinai Health System (08/28/25)
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  • RN /Case Manager-Inpatient-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...System is one of the largest academic medical systems in the New York metro area, with more… more
    Mount Sinai Health System (08/16/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...in an acute care setting with strong care management, utilization review , and payer knowledge. A Case… more
    Guthrie (08/27/25)
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  • Registered Nurse 1 Psychiatric, (NY…

    New York State Civil Service (Orangeburg, NY)
    …Rockland Children's Psychiatric Center (RCPC) is looking to hire a Registered Nurse 1, Psychiatric, to serve as a Utilization Review Coordinator ... NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric, (NY HELPS), Rockland...Proficiency in Microsoft Excel is preferred. URCs at RCPC review electronic and paper clinical medical records for inpatient… more
    New York State Civil Service (07/23/25)
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  • RN Clinical Manager

    CenterWell (Liverpool, NY)
    …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...(NY state requirement) + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (07/12/25)
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