Top 1123 Nurse case managers Jobs in New York, Ny

Nurse Case Manager, Utilization Management
1199SEIU Family of Funds —New York, NY
- $89,400 - $106,100 a year
- Full-time
- Nursing
- RN License
- Mid-level
Managed Care Liaison - New York City Based (remote)
EmblemHealth —New York, NY
- $68,040 - $118,800 a year
- Remote
- Nursing
- Microsoft Outlook
- Management
MetroPlus Case Manager II
NYC Health + Hospitals —New York, NY
- $123,588 - $137,320 a year
- Full-time
- Nursing
- Management
- RN License
- Commuter assistance
- Paid holidays
7d
Case Manager , RN (FH) (Per-Diem Weekends)
Northwell Health —Forest Hills, NY
- $61.81 - $80.72 an hour
- Weekends as needed
- Acute care
- Nursing
- RN License
TB Hotline Coordinator, Bureau of Tuberculosis Control
Agency DEPT OF HEALTH/MENTAL HYGIENE —Queens, NY
- $94,520 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Current TB test
- Wellness program
- Health insurance
Care Manager Registered Nurse
MetroPlus Health Plan —New York, NY
- $112,351 a year
- Full-time
- Hybrid work
- Nursing
- Microsoft Excel
- Microsoft Outlook
Accountable Care Manager
NYC Health + Hospitals —New York, NY
- $122,311 a year
- Online Application
- Acute care
- Nursing
- RN License
- Commuter assistance
- Paid holidays
Discharge Planner - Per Diem
Hospital for Special Surgery —New York, NY
- $74 an hour
- Part-time
- Nursing
- RN License
- Licensed Clinical Social Worker
Junior Public Health Nurse (Part-Time)
Agency DEPT OF HEALTH/MENTAL HYGIENE —New York, NY
- $48.46 an hour
- Part-time
- School experience
- Management
- RN License
- Wellness program
- Health insurance
Nurse Specialist - Patient Support Programs
Atlantis Health —Summit, NJ
- Remote
- Spanish
- Nursing
- Microsoft Excel
- Health insurance
- Vision insurance
Quick Apply
Intake Nurse
summit healthcare staffing —Brooklyn, NY
- $100,000 - $120,000 a year
- Full-time
- Hybrid work
- RN License
- Mid-level
- Office
- Health insurance
- Paid sick time
Quick Apply
Public Health Nurse, Bureau of Public Health Clinics
DEPT OF HEALTH/MENTAL HYGIENE —Queens, NY
- $97,908 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Wellness program
- Health insurance
Case Manager , RN (FH)
Northwell Health —Forest Hills, NY
- $61.81 - $80.72 an hour
- Full-time
- Acute care
- Nursing
- RN License
RN Clinical Operations Manager - PACE Program (Care Delivery Manager)
CenterLight Health System —Queens, NY
- $126,000 - $132,000 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Paid training
- Commuter assistance
14d
Psychiatrist - Collaborative Care
Physician Affiliate Group of New York —Bronx, NY
- $267,900 - $278,200 a year
- Full-time
- Psychiatry
- BC/BE
- Internal Medicine
- AD&D insurance
- Loan repayment program
Quick Apply
RN Case Manager - Home Care
Special Touch Home Care —Brooklyn, NY
- $45 an hour
- Full-time
- Nursing
- RN License
- Mid-level
- Paid time off
Quick Apply
Registered Nurse
Acacia Network —New York, NY
- $80,000 a year
- Full-time
- Nursing
- Addiction Medicine
- RN License
- Paid holidays
- Health insurance
Quick Apply
Skilled Registered Nurse (RN) | Chinese Speaking
Xincon Home-Healthcare Services —New York, NY
- $65 - $105 an hour
- Part-time
- CPR Certification
- Nursing
- RN License
- Paid training
- Flexible schedule
Quick Apply
Outpatient Supervisor, LCSW
CASES —Bronx, NY
- $75,000 - $85,000 a year
- Full-time
- Spanish
- Licensed Clinical Social Worker
- Adults
- Paid holidays
- Health insurance
Quick Apply
PATIENT THROUGHPUT COORDINATOR - RN
University Hospital, Newark NJ —Newark, NJ
- Full-time
- Nursing
- RN License
- Hospital
Quick Apply

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nurse case managers jobs near new york, ny

Nurse Case Manager, Utilization Management

1199SEIU Family of Funds -
New York, NY

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Job Details

Full-time
$89,400 - $106,100 a year

Qualifications

RN License
Medical-surgical
Utilization management
Bachelor of Science in Nursing
Resource utilization in healthcare
Bachelor's degree in nursing

Full Job Description

Requisition #:

7440

# of openings:

Employment Type:

Full time

Position Status:

Permanent

Category:

Non-Bargaining

Workplace Arrangement:

Hybrid

Fund:

1199SEIU National Benefit Fund

Job Classification:

Exempt

Responsibilities

Use industry criteria, benefit plan design, clinical knowledge, and critical thinking to assess, plan and provide, ongoing coordination and management of service delivery through an integrated case management approach
Performs medical necessity review that includes concurrent, prospective, retrospective reviews and 1st level appeals, to ensure compliance with applicable criteria, medical policy, member eligibility, benefits and vendor contracts.
Apply Milliman Care Guidelines, internal Policies and Reference Guides to determine appropriateness of services/equipment that require Prior Authorization
Maintain accurate records of all patient/provider/vendor related interactions in designated medical management system
Apply clinical guidelines, provide recommendations and discuss cases with Medical Consultants
Meet timelines and quality standards related to Utilization Management
Maintain and submit reports and logs on reviewed activities as outlined by the UM program operational procedures,
Identify and participate in quality improvement activities as it relates to internal programs, processes studies and projects
Authorize vendor services using clinically proven criteria to make consistent care decisions
Maintain compliance with all state mandated regulations
Identify and problem solve issues with appropriate services to ensure positive member outcomes utilizing cost efficient covered services
Responsible for abiding by and supporting the care management programs in order to ensure quality and efficient clinical operations
Perform additional duties and projects as assigned by management

Qualifications

Bachelor’s degree Valid New York State Registered Nurse (RN) required
Minimum three (3) years Medical/Surgical experience plus a minimum of two (2) years Utilization Management experience required
BSN and Certification in Case Management a plus
Proficient in application and use of industry standard Utilization Management criteria (Milliman Care Guidelines), Medicare and coverage guidelines, health claims processing, medical coding
Excellent verbal and written communication skills, problem-solving, clinical assessment, care planning skills, and independent decision-making capability
Computer and organizational skills required, ability to manage competing priorities, multi-task with results-oriented outcomes and work in a fast paced environment. Intermediate skills of Microsoft Office systems preferred.

Apply Now

Refine Your Search

nurse case managers jobs in new york, ny

Nurse Case Manager, Utilization Management

Managed Care Liaison - New York City Based (remote)

MetroPlus Case Manager II

Case Manager , RN (FH) (Per-Diem Weekends)

TB Hotline Coordinator, Bureau of Tuberculosis Control

Care Manager Registered Nurse

Accountable Care Manager

Discharge Planner - Per Diem

Junior Public Health Nurse (Part-Time)

Nurse Specialist - Patient Support Programs

Intake Nurse

Public Health Nurse, Bureau of Public Health Clinics

Case Manager , RN (FH)

RN Clinical Operations Manager - PACE Program (Care Delivery Manager)

Psychiatrist - Collaborative Care

RN Case Manager - Home Care

Registered Nurse

Skilled Registered Nurse (RN) | Chinese Speaking

Outpatient Supervisor, LCSW

PATIENT THROUGHPUT COORDINATOR - RN

I want to receive the latest job alert for nurse case managers in new york, ny

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