• Registered Nurse ( RN )…

    Rochester Regional Health (Rochester, NY)
    Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: ... Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
    Rochester Regional Health (12/31/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State… more
    Albany Medical Center (12/03/25)
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  • Case Manager, RN - Case Management

    Northwell Health (Staten Island, NY)
    …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... license to practice as a Registered Professional Nurse in New York State. + Case Management... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
    Northwell Health (01/03/26)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more
    Guthrie (11/26/25)
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  • Case Manager, Registered Nurse

    CVS Health (Albany, NY)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (01/04/26)
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  • Care Coordination Manager ( Registered

    Crouse Hospital (Syracuse, NY)
    management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... agreements. Care Coordination Manager Requirements: + Licensed as a Registered Nurse in New York State +...acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
    Crouse Hospital (12/11/25)
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  • Care Manager - Registered Nurse

    Crouse Hospital (Syracuse, NY)
    …of care. Care Manager Position Requirements: + Must have a current New York State Registered Nurse ( RN ) license. + Graduate from an accredited nursing degree ... Coordination Services team is hiring a Care Manager to review the services delivered to patients and compare it...maintaining the quality of care. + Participates in the utilization management process using standards of care… more
    Crouse Hospital (12/31/25)
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  • VP Care Management Post-Acute Care…

    Kaleida Health (Buffalo, NY)
    …preferred. RN licensure required.** **Experience** **10 years of care management / utilization management experience required in hospital and/or ambulatory ... **VP Care Management Post-Acute Care Transition** **Location:** **Buffalo General Medical...daily oversight of operations, the VP will partner with Utilization Review , Revenue Cycle, and Clinical leadership… more
    Kaleida Health (12/17/25)
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  • Care Manager- Registered Nurse

    Rochester Regional Health (Rochester, NY)
    …BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... holiday every other year. Sign-On Bonus: Yes SUMMARY:As a Registered Nurse - Care Manager, your excellent...+ Three (3) years of acute hospital care, case management or utilization management experience… more
    Rochester Regional Health (12/02/25)
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  • Registered Nurse Case Manager…

    FlexStaff (Lake Success, NY)
    **Req Number** 177188 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria +… more
    FlexStaff (01/07/26)
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