• 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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  • 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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  • Utilization Management Clinician Behavioral…

    CVS Health (Albany, NY)
    …in the state of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification, or experience in state ... Monday through Friday 8:30-5pm EST. No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral… more
    CVS Health (06/25/25)
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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 (06/25/25)
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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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  • Registered Nurse Supervisor 1 (NY…

    New York State Civil Service (Montrose, NY)
    …Mental Health Nurse , (including all parenthetic), Infection Control Nurse , or Senior Utilization Review Nurse ;Or 2. One year in any Grade 16 or ... NY HELP Yes Agency Health, Department of Title Registered Nurse Supervisor 1 (NY HELPS)...Forgiveness (PSLF)* Pension from New York State Employees' Retirement System * Shift & Geographic pay differentials * Affordable… more
    New York State Civil Service (05/21/25)
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  • Case Manager, RN - Case Management

    Northwell Health (Staten Island, NY)
    …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps ... utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of...Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State.… more
    Northwell Health (06/05/25)
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  • RN Clinical Manager

    CenterWell (Westbury, 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...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (06/21/25)
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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 (06/20/25)
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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 (05/13/25)
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  • RN Supervisor Case Management - Full Time…

    Mohawk Valley Health System (Utica, NY)
    …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... RN Supervisor Case Management - Full Time -...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
    Mohawk Valley Health System (06/14/25)
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  • Nurse Case Manager - Full Time, DAYS

    Albany Medical Center (Albany, NY)
    …8. Basic knowledge of computer systems with skills applicable to utilization review process. Mission, Core Values and Service Excellence 1. Contributes ... the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission...strategies for variance reduction. Qualifications and Ideal Characteristics 1. Registered nurse with a current license. 2.… more
    Albany Medical Center (06/06/25)
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  • Registered Nurse Community…

    Veterans Affairs, Veterans Health Administration (Canandaigua, NY)
    …of Assigned Duties: The Registered Nurse Community Care (CC) Coordinator Registered Nurse ( RN ) is responsible for executing a streamlined approach to ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (06/18/25)
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  • Director of Case Management

    Stony Brook University (Stony Brook, NY)
    …design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead initiatives to improve patient ... degree. * Possession of license to practice as a registered nurse in New York State *...and collaboration with Social Work Services * Knowledge of Utilization Review and Denial/Appeals * Knowledge of… more
    Stony Brook University (06/24/25)
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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 (06/14/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Amsterdam, NY)
    …management company. Maintains current knowledge of disease management software and systems as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, ... for the integrity and safety of the facility water system . + Must be knowledgeable in the operation of...+ Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic,… more
    Fresenius Medical Center (06/14/25)
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  • Nurse Navigator- Canton-Potsdam Hospital

    Rochester Regional Health (Rochester, NY)
    …LICENSES / CERTIFICATIONS: BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... Job Title: Nurse NavigatorDepartment: Oncology Location: Canton-Potsdam Hospital Hours Per...after admission-within the first 12 to 24 hours. Applies utilization review criteria to assess and document… more
    Rochester Regional Health (06/18/25)
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  • Nurse Navigator - Gynecological Oncology

    Rochester Regional Health (Rochester, NY)
    …LICENSES / CERTIFICATIONS: BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... Job Title: Nurse Navigator - Gynecological Oncology Location: Rochester General...after admission-within the first 12 to 24 hours. Applies utilization review criteria to assess and document… more
    Rochester Regional Health (05/29/25)
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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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