• 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. (05/30/25)
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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 (06/25/25)
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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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  • Manager , Utilization Management

    Healthfirst (NY)
    …across a variety of treatment settings for high risk, complex populations + Certified Case Manager + Interqual, Milliman, and/or TruCare knowledge + Knowledge of ... preauthorization of outpatient or inpatient services + Knowledge of utilization management/quality management case philosophies and reporting requirements… more
    Healthfirst (06/11/25)
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  • Utilization Review Manager

    Phoenix House (Wainscott, NY)
    ** Utilization Review Manager ** **Job Details** **Job Location** East Hampton Residential - Wainscott, NY **Position Type** Full Time **Education Level** Graduate ... Morning **Job Category** Nonprofit - Social Services **Description** **SUMMARY** The Utilization Review (UR) Manager coordinates commercial, and Medicaid Managed… more
    Phoenix House (06/25/25)
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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 (05/08/25)
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  • Nurse Case Manager - Full Time, DAYS

    Albany Medical Center (Albany, NY)
    …Shift: Day (United States of America) Salary Range: $71,612.39 - $110,999.20 The Case Manager is accountable to facilitate the interdisciplinary team to plan, ... evaluate patient care for assigned service line across the continuum of care. The Case Manager works proactively with the Quality Improvement Teams, patient care… more
    Albany Medical Center (06/06/25)
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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 (05/13/25)
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  • Case Manager , RN- Case

    Northwell Health (Staten Island, NY)
    …delays and resolves issues with appropriate departments. + Identifies appropriate utilization of Social Work Services and makes referrals when appropriate. + ... + Serves as a resource to the health care team regarding quality, utilization of clinical resources, payer, and reimbursement issues. + Works with on-site screeners… more
    Northwell Health (06/05/25)
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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 (06/12/25)
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  • Case Manager , RN (Multiple…

    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 (06/18/25)
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  • Nurse Case Manager - Full Time, Days

    Nuvance Health (Poughkeepsie, NY)
    …affiliates, Position Summary: Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support ... physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within the...cases are a priority and at a minimum the case manager reviews observation cases daily. 3.… more
    Nuvance Health (04/26/25)
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  • Case Manager

    St. Catherine's Center for Children (Hudson, NY)
    CASE MANAGER : CCHI/ COLUMBIA-GREENE SUPPORTED HOUSING Full Position Title : Case Manager , Columbia County Homeless Intervention ("CCHI") / ... about us, please visit our website at: www.st-cath.org Position Overview: The Case Manager , Columbia Co. Homeless Intervention (CCHI) / Columbia-Greene Supported… more
    St. Catherine's Center for Children (05/28/25)
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  • RN Case Manager - Case

    Guthrie (Corning, NY)
    …RNs! Position Summary: In collaboration with the interdisciplinary healthcare team, the Case Manager will coordinate the flow of services throughout the ... Documents in a through, concise & timely manner as deemed appropriate by the case manager . 3. Identifies individual patient discharge needs in collaboration with… more
    Guthrie (06/24/25)
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  • Nurse Case Manager

    Brighton Health Plan Solutions, LLC (New York, NY)
    …(BHPS) provides Case Management services to its clients. Cases are maintained by the Nurse Case manager . The Nurse Case Manager reports to the ... Manager of Case Management. Responsible for developing and managing the case management program and providing case management services to members. This… more
    Brighton Health Plan Solutions, LLC (05/20/25)
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  • Nurse Case Manager

    Albany Medical Center (Albany, NY)
    …Shift: Day (United States of America) Salary Range: $71,612.39 - $110,999.20 The Case Manager is accountable to facilitate the interdisciplinary team to plan, ... assigned service line across the continuum of care. The Case Manager works proactively with the Quality...Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources… more
    Albany Medical Center (06/26/25)
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  • Workers Compensation, Nurse Case

    Brighton Health Plan Solutions, LLC (New York, NY)
    …of necessary medical services, and the evaluation of coverage under the Plan. The Nurse Case Manager reports to the Casualty Department Manager . This job ... About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Group Health and Workers' Compensation… more
    Brighton Health Plan Solutions, LLC (06/19/25)
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  • RN Case Manager - Case

    Mohawk Valley Health System (Utica, NY)
    RN Case Manager - Case Management - per diem Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of Case Management ... compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review/ case management experience or social work experience.… more
    Mohawk Valley Health System (05/13/25)
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  • Case Manager , Medicaid Long Term…

    MVP Health Care (Schenectady, NY)
    Case Manager , Medicaid Long Term Support Program 625 State St, Schenectady, NY 12305, USA * Rochester, NY, USA * Tarrytown, NY, USA Req #2653 Thursday, June 12, ... continuous improvement. To achieve this, we're looking for a ** Case Manager , Medicaid Long Term Support Program**...key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that… more
    MVP Health Care (06/13/25)
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  • Case Manager

    Stony Brook University (Stony Brook, NY)
    Case Manager **Position Summary** At Stony Brook Medicine, a ** Case Manager ** is a valuable member of our team, who provides clinical services to our ... to our high standard of excellence. **Duties of a Case Manager in the Care Management Department...the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity… more
    Stony Brook University (06/21/25)
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