RN Utilization Specialist, Case Management (Hybrid)
Memorial Sloan Kettering Cancer Center
Memorial Sloan Kettering Cancer Center in New York is seeking a Utilization Specialist to join our Case Management team. The role focuses on admission, concurrent, retrospective, and Medicare reviews to determine medical necessity and ensure appropriate levels of care.
You will collaborate with case managers, providers, and insurers to support treatment plans, authorization reviews, and discharge planning, while documenting in accordance with regulatory requirements.
#J-18808-LjbffrVacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the RN Utilization Specialist, Case Management (Hybrid) in New York, NY vacancy
$69.39k - $88.61k
Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role... ...United States. The position supports case management, authorization, compliance, and... ...s degree in a related field, an active RN/Social Work/Clinical Counselor license,...SuggestedRemote jobFull time- HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and... ...ideal candidate has an RN license with 1 year UR/UM or Case Management experience and 3 years RN in acute care, with strong collaboration...SuggestedRemote job
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure... ...team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization review...SuggestedWork at officeRemote work
HealthHelp
New York, NY4 days ago - 100 LCMC Health is seeking an RN for Utilization Review to support patient throughput and physician communication while ensuring payer requirements are met. Responsibilities include care reviews, medical necessity determinations, and accurate status assignments per...SuggestedShift workWeekend work
100 LCMC Health
New York, NY5 days ago - ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...SuggestedRemote work
Cleveland Clinic
New York, NY2 days ago - ...Community Memorial Hospital, Inc. is seeking an experienced RN to lead utilization review activities at our Hamilton, NY facility. You will... ...medical necessity and level of care. Work with physicians, case managers, and payers to obtain authorizations, report delays, and...
Community Memorial Health System
New York, NY4 days ago - ...Cleveland Clinic Health System is seeking an experienced Utilization Management RN Reviewer to work remotely with a focus on admission, concurrent and retrospective reviews. The role supports payer communications, data collection, and clinical decision-making to ensure...Work at officeRemote work
CCF
New York, NY2 days ago - ...advanced care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement through... ...based on utilization review medical necessity criteria. Refers cases for secondary review when appropriate. Refers and consult...Temporary workWork experience placementLive outRemote workFlexible hours
Vanderbilt University Medical Center
New York, NY3 days ago - ...Health is seeking an experienced Registered Nurse to support utilization management and care coordination from a remote work setup within the United... .... Candidates should have 2+ years of acute/critical care RN experience and an active RN license in their state of residence...Remote work
CVS Health
New York, NY17 hours ago - Enlyte is seeking a Field Case Manager to coordinate treatment plans with physicians, employers, and patients. You will ensure cost-effective... ...optimal recovery and return to work. The role requires an RN with 2+ years clinical practice and ability to travel locally....Remote work
$90k - $100k
...Transition of Care Nurse Care Manager (Registered Nurse) – Hybrid Compensation Salary... ...care Collaborate with utilization management teams to review... ...State Registered Nurse (RN) license and registration... ...knowledge of discharge planning, case management, and...Contract workRemote workShift workRCM Healthcare Services
New York, NY4 days ago- ...Services is seeking a Transition of Care Nurse Care Manager (RN) in Midtown Manhattan for a hybrid schedule. The role focuses on reducing care disruptions... ...discharge planning coordination, collaboration with utilization management, post-discharge outreach, and medication...Remote work
RCM Health Care Services
New York, NY18 hours ago $100k - $120k
...Job Title: RN Case Manager – Behavioral Health Compensation Salary Range: $100,000... ...year DOE Location: Brooklyn , NY – Hybrid / Field-Based Position Summary As... ...monitoring member eligibility and service utilization Support discharge planning, care...Contract workWork at officeShift workRCM Health Care Services
New York, NY3 days ago- ...Systems SpecialistOur utility client in NYC is looking for an AMI Systems Specialist for application support... .... This is a 12+ month hybrid role.Project Role: The... ...the AMI Meter Asset Management System (MAMS), ProField... ...end flow diagrams, use cases, complex APIs and...For contractors
DONNELLY & MOORE
New York, NY5 days ago - ...Central (2pm to 11pm Eastern). The Utilization Review Clinician is... ...conducting patient evaluations, managing admissions and informational visits... ...guidelines and escalating cases to medical directors as needed... ...or therapy experience Active RN, OT, or PT license Preferred Qualifications...Full timeWork experience placementWork at officeRemote workWorldwideMonday to FridayShift work
WellSky
New York, NY3 days ago - ...experienced Registered Nurse for an 8-week travel assignment in Utilization Review, focusing on clinical investigations, medical record... ...non-acute utilization review. The role requires an active NY RN license, AHA BLS certification, and at least 1 year of non-acute...Monday to Friday
White Glove Placement New York
New York, NY3 days ago $100 per hour
...Registered Nurse for an 8-week travel assignment in Utilization Review. This role is ideal for an RN with experience in clinical investigations, medical... ...Details Specialty: Utilization Review / Case Management Assignment Length: 8 weeks Schedule: Monday...Monday to FridayWhite Glove Placement New York
New York, NY3 days ago- ...Registered Nurse (RN) - Utilization Management - PRN - North FultonWe use cookies to offer you a better browsing experience analyze site traffic,... ...day, on any of the 7 days per week, utilizing Indicia for Case Management, and performs clinical reviews through document...Part timeReliefShift work
WellStar Health System
New York, NY18 hours ago - ...Description This role is specific to the LTSS department. RN will be responsible for providing case management services and evaluating the necessity/... ...services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards...Contract workRemote workMonday to FridayFlexible hours
HealthCare Support
New York, NY4 days ago $85k - $106.3k
...and cost-effective health care services. Manages providers, members, team, or care... ...representatives, and discharge planners in utilization tracking, care coordination, and monitoring... ...or consults with medical directors when case does not meet medical necessity criteria...Flexible hoursCredenza Health
New York, NY2 days ago- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related... .... This role offers either remote work or a home-office hybrid setup, with collaboration across clinical staff to ensure...Remote jobWork from homeHome office
- ...SUMMARY: Responsible for clinical review of utilization requests and assessment and... ...an active team member of the Utilization Management Team. KEY RESPONSIBILITIES: Performs utilization... ...timeframes. Appropriately identifies and refers cases that do not meet established clinical...
$105k - $116.8k
HYBRID Pediatric Hospice RN for Bronx NY with 15K sign on bonus and PENSION, 403B, 4 weeks vacation, Company paid Life Insurance This Jobot Job... ...experience for a newly created Pediatric Hospice RN Case Manager role covering the Bronx. Local Bronx and Yonkers RN candidates...Temporary workLocal areaRelocation packageFlexible hoursJobot
New York, NY13 days ago$52 - $56 per hour
...Contract RN For New York Health PlanYou've done UM. You've worked appeals. Now find... ...necessity judgment you built in utilization management. 100% remote (U.S.) | Contract | $52–$5... ...home health, DME and LTSS casesPrepare case files for Medical Director reviewWrite...Contract workRemote workAfternoon shiftPhaxis
New York, NY17 hours ago- ...and The Power of Every One. Job Title Utilization Management RN Reviewer Location Cleveland Facility... ...the world. Utilization Management (UM) Specialists perform UM activities, such as... ...evidence that the UR process for the case was followed. Attend all staff meeting...Full timeWork at officeRemote workShift workWeekend work
CCF
New York, NY2 days ago - ...University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care....Full timeRemote work
University of Miami
New York, NY2 days ago - ...OU Health is seeking a Case Manager, RN - Utilization Review (PRN) to evaluate medical necessity and appropriate care, securing authorizations and coordinating with payors, patients, and interdisciplinary teams. This role emphasizes HIPAA compliance and strong communication...ReliefRemote work
OU Health
New York, NY5 days ago - ...Littleflowerny is seeking a Nurse Case Manager (RN/LPN) in Brooklyn, NY. The role focuses on coordinating medical and mental health care for... ...a multidisciplinary team. The position is full-time and hybrid, with three days in-office at the flagship Brooklyn location,...Full timeWork at office
LittleFlowerNY
New York, NY18 hours ago - ...Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health, Oklahoma City, OK. Get to Know Your Team: INTEGRIS Health, Oklahoma's largest not-for-profit health system, is seeking...Full timeWork at officeRemote workWeekend work
INTEGRIS Health
New York, NY15 hours ago - ...CorVel in the United States is seeking a Utilization Review Case Manager to gather demographic and clinical information, certify medical necessity, and assign appropriate length of stay for inpatient and outpatient treatment. This remote role requires strong CPT/ICD coding...Remote work
NurseRemotely
New York, NY3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Utilization Specialist, Case Management (Hybrid). Be the first to apply!
Related searches