• Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …efforts to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... position and also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case /Care Management Position… more
    Helio Health Inc. (05/02/25)
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  • Staff Nurse- Case Manager - Mount…

    Mount Sinai Health System (New York, NY)
    …in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years? ... **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED… more
    Mount Sinai Health System (04/16/25)
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  • RN/ Case Manager -MSH- Case

    Mount Sinai Health System (New York, NY)
    **Job Description** **RN/ Case Manager MSH Case ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... are not limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using… more
    Mount Sinai Health System (04/15/25)
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  • Case Manager RN- Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    …in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years? ... **Job Description** The Case Manager (CM) will be responsible...1. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management… more
    Mount Sinai Health System (04/22/25)
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  • Registered Nurse Care Manager

    Catholic Health (Buffalo, NY)
    …prior insurance /managed care/ utilization review experience in the role of a Case Manager or Disease Manager , Population Health, Discharge Planning or ... to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review, as an active member of...or obtained within 6 months + National Certification in Case Management preferred EXPERIENCE + Two (2) years medical… more
    Catholic Health (05/01/25)
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  • Case Manager - Case

    Arnot Health (Elmira, NY)
    …processes related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge ... Job Description MAIN FUNCTION: The Case Manager coordinates, negotiates, procures services... case managers. f. The Case Manager tracks and trends LOS, resource utilization ,… more
    Arnot Health (02/06/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal patient, clinical, and operational outcomes timely, ... coordinated, and in cost effective manners. The Acute Case Manager has the responsibility, accountability, and...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case more
    Guthrie (02/11/25)
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  • Pharmacist, Utilization Mgmt (CA & WA)

    Molina Healthcare (Rochester, NY)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and cost control issues… more
    Molina Healthcare (05/02/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …patient's required needs and covered services. Support services provided by the Case Manager include, but are not limited to, utilization review, case ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review, and discharge planning… more
    Ellis Medicine (04/25/25)
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  • Case Manager , RN or Licensed…

    Excellus BlueCross BlueShield (Rochester, NY)
    …auditor within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and ... Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for… more
    Excellus BlueCross BlueShield (05/01/25)
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