• Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …clinical license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more
    Centene Corporation (10/03/25)
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  • Registered Nurse 1 Psychiatric (NY Helps),…

    New York State Civil Service (New York, NY)
    Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , P26749 Occupational Category Health Care, Human/Social Services ... York State NY Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily … more
    New York State Civil Service (08/14/25)
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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Manhattan Psychiatric Center, P27078 Occupational Category Health ... Code 10035 Duties Description Manhattan Psychiatric Center is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and… more
    New York State Civil Service (10/02/25)
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  • Asst Utilization Coordinator

    WMCHealth (Valhalla, NY)
    …implementation or investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester Medical ... York State Department of Education, as a registered professional nurse . Training and Experience: three years of experience where...of which must have been in the area of utilization review , quality assurance, risk management or… more
    WMCHealth (10/07/25)
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  • Asst Utilization Coordinator

    WMCHealth (Valhalla, NY)
    …implementation or investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester Medical ... York State Department of Education, as a registered professional nurse . Training and Experience: three years of experience where...of which must have been in the area of utilization review , quality assurance, risk management or… more
    WMCHealth (09/12/25)
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  • Insurance Specialist-Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
    Mount Sinai Health System (07/23/25)
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  • Clinical Review Nurse - Prior…

    Centene Corporation (New York, NY)
    …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... + Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to… more
    Centene Corporation (10/05/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Yonkers, NY)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
    Molina Healthcare (09/06/25)
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  • Nurse Practitioner-Cardiothoracic- Mount…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Job Title : Nurse Practitioner- Cardiothoracic- Mount Sinai Hospital - Full Time - Night** A nurse practitioner (NP) as described in Title ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
    Mount Sinai Health System (08/03/25)
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  • Nurse Practitioner - Cardiology - Mount…

    Mount Sinai Health System (New York, NY)
    **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion… more
    Mount Sinai Health System (10/04/25)
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  • Nurse Practitioner - Cancer Center - Mount…

    Mount Sinai Health System (Long Island City, NY)
    **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion… more
    Mount Sinai Health System (09/23/25)
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  • Registered Nurse

    City of New York (New York, NY)
    …required; make professional recommendations accordingly. - Keep abreast of medical and utilization review techniques and developments relative to the nursing ... Medicaid Eligibility Unit is responsible for the Medicaid eligibility review and processing of initial applications, change actions, and...Nurse in the Bureau of Medical and Professional Review (BMPR) of Home Care Services Program. As the… more
    City of New York (09/27/25)
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  • Clinical Manager Registered Nurse - RN…

    Fresenius Medical Center (New York, NY)
    …and programs. Collaborates with the Medical Director and the Clinical Coordinator /Charge Nurse or Nurse Supervisor regarding the provision of quality patient ... closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the Medical Director, and the… more
    Fresenius Medical Center (09/12/25)
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  • VPS Psychiatric Nurse Practitioner

    City of New York (New York, NY)
    …CAS Visiting Psychiatric Services (VPS) Unit is recruiting for two (2) Psychiatric Nurse Practitioner for the roles below. Under the supervision of the Medical ... for independent judgement within NYS licensing guidelines, the VPS Psychiatric Nurse Practitioner is responsible for performing psychiatric evaluations of clients at… more
    City of New York (08/08/25)
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  • Registered Nurse - Surgical ICU

    Veterans Affairs, Veterans Health Administration (New York, NY)
    …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The Surgical Intensive Care Registered Nurse (RN) is responsible for providing competent, evidence-based care to assigned patients and oversight of… more
    Veterans Affairs, Veterans Health Administration (10/08/25)
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  • Nurse Practitioner Mobile - Part Time

    Project Renewal, Inc. (New York, NY)
    …in the development and implementation of quality assurance management and utilization review + Participates in interdisciplinary meetings with shelter ... Title: Primary Care Nurse Practitioner - Part Time Program: Healthcare Department...$87,000 depending on experience Position Overview: The Primary Care Nurse Practitioner working in Mobile Health is responsible for… more
    Project Renewal, Inc. (10/07/25)
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  • Psychiatric Nurse Practitioner

    Wellpath (Valhalla, NY)
    …care through adherence to policies and procedures for admission and transfer, utilization review , and referrals. + Assumes responsibility and accountability for ... of care support. **How you make a difference** The Psychiatric Nurse Practitioner(Psych NP)follows established policies and procedures and state guidelines, ensuring… more
    Wellpath (10/02/25)
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  • Hospice Registered Nurse - Full Time, Days,…

    Atlantic Health System (Newark, NJ)
    Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work Monday - Friday from 8 AM to 4 PM in the Morris, ... of care for the patient and family Ensures appropriate utilization of services + Maintains visit productivity standards +...100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 -… more
    Atlantic Health System (08/28/25)
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  • Licensed Practical Nurse Relief -DDA106…

    WellLife Network (South Richmond Hill, NY)
    …location and schedules are subject to change. + Attend certification inspections, utilization review and independent professional reviews as needed. + Attend ... Licensed Practical Nurse Relief -DDA106 - On-Call Job Details Job...medical pre-admission evaluations and screening of prospective clients. + Review and update persons with disabilities pre-admission evaluation within… more
    WellLife Network (08/07/25)
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  • Respiratory Registered Nurse

    Chatham Hills Subacute Care Center (Chatham, NJ)
    …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... a week 37.5 - 40 hours per week Respiratory Nurse (RN) We are searching for a highly motivated,...communications within the facility with the director of nursing, nurse managers, and admissions coordinator to assist in development… more
    Chatham Hills Subacute Care Center (09/23/25)
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