• Utilization Review Nurse

    CDPHP (Latham, NY)
    …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
    CDPHP (09/23/25)
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  • Temporary Behavioral Health Utilization

    CDPHP (Latham, NY)
    …values and invites you to be a part of that experience. The BH Utilization Specialist is responsible for coordination of care for CDPHP members across the continuum, ... an acute or subacute level of care. The BH Utilization Specialist will conduct telephonic care coordination activities with...required) + In lieu of behavioral health license, Registered Nurse with valid New York State license, with experience… more
    CDPHP (10/16/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Latham, NY)
    **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more
    Elevance Health (10/17/25)
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  • Nurse Manager - Outpatient Ortho Office…

    Trinity Health (Latham, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse Manager - New Ortho Office - Latham, NY** If you are looking for a Clinical Nurse ... evaluations, regularly scheduled program reviews, facility rounds and program utilization statistics. + Develops objective performance measures which differentiate… more
    Trinity Health (09/12/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …services provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and ... in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly...transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or… more
    Ellis Medicine (10/24/25)
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  • Case Manager, Medicaid Long Term Support Program

    MVP Health Care (Schenectady, NY)
    …you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after ... **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes assessment, planning,… more
    MVP Health Care (10/23/25)
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  • Pre-Service Representative

    St. Mary's Healthcare (Amsterdam, NY)
    …the referral the patient has presented. Schedules requested exams to maximize equipment utilization by time and location, review open slots and manage waitlist ... other providers as needed. Communicates changes in the patient schedule, STATS, nurse requirements, add-ons to appropriate parties. Opens faxes from scheduling fax… more
    St. Mary's Healthcare (10/24/25)
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  • Medical Management Clinician

    Elevance Health (Latham, NY)
    …equivalent. + Requires a minimum of 4 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN license ... case types that do not require the training or skill of a registered nurse . **Primary duties may include but are not limited to:** + Responsible for moderately… more
    Elevance Health (10/25/25)
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