• Stony Brook University (Stony Brook, NY)
    Registered Nurse (T&RC) - Blood Donor - Per Diem **Position Summary** At Stony Brook Medicine, our Registered Nurses are critical members of the team who ... while adhering to a medical regimen. **Duties of a Registered Nurse in the Blood Donor Department...Donor and Therapeutic Apheresis as assigned.. + Perform blood utilization quality assurance, donor related work as assigned. +… more
    DirectEmployers Association (10/11/25)
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  • Stony Brook University (Stony Brook, NY)
    …development, implementation and monitoring of the organizations case management and utilization review functions. + Manages daily operations, which includes ... of resources, coordination of care across the continuum, utilization review , discharge and transition planning and...Qualifications:** * Possession of license to practice as a registered nurse in New York State. *… more
    DirectEmployers Association (09/23/25)
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  • Utilization Review Registered

    Centene Corporation (New York, NY)
    …requires NY RN Licensure as well as a State Issued NY ID.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more
    Centene Corporation (10/15/25)
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  • Registered Nurse 1 Psychiatric (NY…

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , ... 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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  • 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 ... Nurse in the Bureau of Medical and Professional Review (BMPR) of Home Care Services Program. As the...- 50935 Qualifications 1. A valid New York State Registered Nurse License and completion of one… more
    City of New York (09/27/25)
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  • Clinical Manager Registered Nurse

    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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  • 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 ... the New York State Department of Education, as a registered professional nurse . Training and Experience: three...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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  • Registered Nurse Case Manager

    Northwell Health (Manhasset, NY)
    …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... + Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + Submits… more
    Northwell Health (10/20/25)
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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 highly motivated,...communications within the facility with the director of nursing, nurse managers, and admissions coordinator to assist in development… more
    Glengariff Rehabilitation and Healthcare Center (10/22/25)
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  • RN Medical Claim Review Nurse Remote

    Molina Healthcare (Yonkers, NY)
    JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims ... a hospital setting, including at least 1 year of utilization review , medical claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… more
    Molina Healthcare (10/19/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Bayside, NY)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (08/08/25)
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  • Clinical Review Nurse - Prior…

    Centene Corporation (New York, NY)
    …+ LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: $26.50 - $47.59 per hour Centene ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… 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)
    …Additional Detail** + Licensure: New York State License with current registration as a registered nurse . + State Certification: Certified by the New York State ... the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
    Mount Sinai Health System (08/03/25)
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  • Nurse Practitioner - Cancer Center - Mount…

    Mount Sinai Health System (Long Island City, NY)
    …REQUIREMENTS** Licensure: New York State License with current registration as a registered nurse . State Certification: Certified by the New York State ... as follows: a.Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR...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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  • Nurse Practitioner - Klingenstein 3 NICU…

    Mount Sinai Health System (New York, NY)
    …Additional Detail** 1. Licensure: New York State License with current registration as a registered nurse . 2. State Certification: Certified by the New York State ... the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
    Mount Sinai Health System (09/26/25)
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  • Head Nurse (Substitute)

    State of Connecticut, Department of Administrative Services (Bridgeport, CT)
    …eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/ Registered - Nurse /RN-Licensure-by-Endorsement) for CT ... (https://www.elicense.ct.gov/) online (expand the 'Public Health Practitioners' grouping, select ' Registered Nurse ' and then 'Start'; + Request verification… more
    State of Connecticut, Department of Administrative Services (10/15/25)
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  • VPS Psychiatric Nurse Practitioner

    City of New York (New York, NY)
    …requirement above, candidates must have three years of full-time satisfactory experience as a Registered Nurse , two of which must have been in a supervisory ... with the referring agency and the client's caseworker. 2. Review all available clinically relevant material, including referral information,...have three years of full-time satisfactory experience as a Registered Nurse , one of which must have… more
    City of New York (08/08/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Yonkers, NY)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
    Molina Healthcare (10/22/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Yonkers, NY)
    …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
    Molina Healthcare (10/18/25)
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