• UM Behavioral Health

    Humana (Albany, NY)
    …our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the ... health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and… more
    Humana (09/09/25)
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  • Behavioral Health Case Manager

    Independent Health (Buffalo, NY)
    …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Behavioral Health Case Manager is primarily responsible for managing ... behavioral health benefits through the administration of quality improvement functions....licensed family or marriage therapist (LMFT) or active registered nurse (RN) in NYS required. Certified Case Manager (CCM)… more
    Independent Health (08/29/25)
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  • Case Manager, RN or Licensed Behavioral

    Excellus BlueCross BlueShield (Dewitt, NY)
    …those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, ... health care services. Examples may include: Utilization Management, Quality, Behavioral Health , Pharmacy, Registered Dietitian and Respiratory Therapist +… more
    Excellus BlueCross BlueShield (08/28/25)
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  • Community Health Assessment Field…

    Excellus BlueCross BlueShield (Rochester, NY)
    …of medical and health care services for members. The SN CHA Nurse may also perform other technical and administrative tasks essential to the efficient operation ... in their home and/or facility. The incumbent utilizes required NYS Community Health Assessment (CHA) Tools to determine functional status, medical, behavioral ,… more
    Excellus BlueCross BlueShield (08/19/25)
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  • Care Review Clinician, Prior Auth (RN) Pega Float…

    Molina Healthcare (NY)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... this position we are hiring for a float team to support PEGA UM systems throughout multiple states.** **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services… more
    Molina Healthcare (07/12/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Syracuse, NY)
    …candidate will have experience with UM and prior authorization, within both Physical Health and Behavioral Health . Candidates with a Behavioral ... an integrated delivery of care across the continuum, including behavioral health and long-term care, for members...teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other… more
    Molina Healthcare (08/16/25)
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  • Care Review Clinician, Prior Authorization

    Molina Healthcare (Buffalo, NY)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... teams to promote Molina Care Model + Adheres to UM policies and procedures. **JOB QUALIFICATIONS** **Required Education** Any...field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required… more
    Molina Healthcare (08/31/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (Albany, NY)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more
    Molina Healthcare (08/31/25)
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