• Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal communication skills.* Working ... stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and… more
    Albany Medical Center (04/25/25)
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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 (04/05/25)
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  • Utilization Review Counselor

    Seafield Center, Inc. (Westhampton Beach, NY)
    Title: Utilization Review Counselor ID:5712 Department: Utilization Review Location:Westhampton Beach Description Full-Time Opportunity Available + ... Program + Retirement Program (401k) + 8 Paid Holidays MAIN FUNCTION: + Review appropriateness and clinical necessity of admissions, continued stays, and discharges +… more
    Seafield Center, Inc. (04/02/25)
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  • Trainer - Clinical Services - Utilization

    Molina Healthcare (Albany, NY)
    …knowledge on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or Bachelor's ... settings. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) or State Clinical Social Worker/Counseling… more
    Molina Healthcare (05/07/25)
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  • Assistant Director of Case Management/…

    Mount Sinai Health System (New York, NY)
    …influence other services by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data collection, data received ... :** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight… more
    Mount Sinai Health System (04/04/25)
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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. ... 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 (04/15/25)
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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. + ... + 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 (05/08/25)
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  • Case Manager RN - Mount Sinai West- Full…

    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 (04/22/25)
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  • Staff Nurse - Case Manager- Mount Sinai…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients and ... Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or...System is one of the largest academic medical systems in the New York metro area, with more… more
    Mount Sinai Health System (04/16/25)
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  • Registered Nurse Coordinator…

    Trinity Health (Syracuse, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... outcomes are achieved, and high-quality professional practice is realized. **Position Purpose:** Registered Nurse Coordinator is a dynamic leadership role that… more
    Trinity Health (04/02/25)
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  • RN Clinical Manager Home Health

    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 (04/01/25)
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  • Respiratory Registered Nurse

    Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
    …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... 40 hours per week Respiratory Therapist (RT) / Respiratory Nurse ( RN ) We are searching for a...of respiratory disease and diseases that affect the respiratory system . o Ability to use respiratory therapy equipment. o… more
    Glengariff Rehabilitation and Healthcare Center (04/19/25)
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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 (02/11/25)
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  • Clinical Manager Registered Nurse

    Fresenius Medical Center (New York, NY)
    …+ Collaborates closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the ... + Addressing patient concerns, issues, and questions including the review of patient satisfaction surveys. + Developing and communicating...CQI tools. + Works with the Clinical Coordinator /Charge RN or Nurse Supervisor and Medical Director… more
    Fresenius Medical Center (04/24/25)
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  • Nurse Case Manager: Full Time, DAYS

    Albany Medical Center (Albany, NY)
    …+ Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure ... works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to achieve… more
    Albany Medical Center (05/08/25)
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  • RN Uniform System Assessor field…

    Molina Healthcare (Buffalo, NY)
    …* UAS experience * Experience conducting home visits Required Licensure or Certification: * Registered Nurse ( RN ) State Specific Requirements: * Must reside ... for Medicaid and Medicare. We are looking for a RN candidate with a Uniform System Assessor...and using durable medical equipment (DME). * Experience in utilization review , concurrent review and/or… more
    Molina Healthcare (04/30/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Albany, NY)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
    Sharecare (05/10/25)
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  • Registered Nurse IV, Acute Care…

    Bassett Healthcare (Cooperstown, NY)
    …before 12/19/17 are/remain exempt from this requirement. Experience: Minimum 5 years of Registered Nurse experience, 3 years must be in relevant practice area, ... required Must be able to perform as preceptor, required Minimum 2 years Registered Nurse experience in relevant practice area, if Education is BSN or MSN,… more
    Bassett Healthcare (03/13/25)
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  • Unit Clinical Care Coordinator RN Unit C3

    Bassett Healthcare (Cooperstown, NY)
    …a principle liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed ... management experience, preferred License/Certifications: Current NYS Licensure as a Registered Professional Nurse , required Case management certification,… more
    Bassett Healthcare (04/30/25)
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  • Investigator, SIU RN

    Molina Healthcare (Albany, NY)
    …abuse through the identification of aberrant coding and/or billing patterns through utilization review . * Incorporate leadership and communication skills to work ... care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) license in good standing. **PREFERRED… more
    Molina Healthcare (04/20/25)
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