• UM RN

    Centers Plan for Healthy Living (Jamaica, NY)
    UM RN 90-27 Sutphin Blvd, Jamaica, NY 11435, USA Req #12129 Monday, December 2, 2024 Centers Plan for Healthy Living's goal is to create the ultimate healthcare ... and plans they need for healthy living. JOB SUMMARY: The Utilization Management nurse works within a multidisciplinary team to help identify and manage members who… more
    Centers Plan for Healthy Living (12/03/24)
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  • Transition of Care Registered Nurse

    VNS Health (Manhattan, NY)
    …assigned. Qualifications Licenses and Certifications: + Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... Certified Case Manager preferred + For SelectHealth ETE Only: Nurse Practitioner (NP) certification with background or degree in...+ Knowledge of Milliman criteria (MCG) preferred + For UM Only: Experience must be with a Managed Care… more
    VNS Health (01/02/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (New York, NY)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (12/20/24)
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  • Clinical Evalution Manager, RN - mostly…

    VNS Health (Manhattan, NY)
    …as assigned. Qualifications Licenses and Certifications:Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... State requiredCertified Case Manager preferredFor SelectHealth ETE Only: Nurse Practitioner (NP) certification with background or degree in Public Health… more
    VNS Health (01/03/25)
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  • CHS Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …party contractual changes from the Managed Care Department and applies to UM and appeals management processes. | Works collaboratively with physicians, physician ... | Graduate of an accredited Nursing School or College; current New York State, RN License required, BSN Bachelor of Science in Nursing or Health preferred. | Minimum… more
    Catholic Health Services (12/19/24)
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