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Overview Behavioral Health Counselors provide supportive counseling, advocacy, and education to help patients and their families navigate mental illness, access community resources, and manage symptoms to help them remain safely in the community This is an experienced, master’s level social services role that provides direct care as part of a team. Join us in building on our 130-year history and become a part of the Future of Care that is strengthening communities with high quality, integrated behavioral health programs. VNS Health Behavioral Health team members provide vital client-centered behavioral health care to New Yorkers most in need, across all stages of life and mental well-being. We deliver care wherever our clients are, including outpatient clinics, clients’ homes, and the community. Our short- and long-term service models include acute, transitional, and intensive care management programs that impact the most vulnerable populations, from children, to adolescents, to aging adults. As part of our fast-growing Behavioral Health team, you’ll have an opportunity to develop and advance your skills, whether you’re early in your career or an experienced professional. What We Provide • Attractive sign-on bonus and referral bonus opportunities, • Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays, • Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability, • Employer-matched retirement saving funds, • Personal and financial wellness programs, • Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care, • Generous tuition reimbursement for qualifying degrees, • Opportunities for professional growth and career advancement, • Internal mobility, CEU credits, and advancement opportunities, • Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals What You Will Do • Performs social work assessments of patients/families; opens cases as appropriate, • Develops treatment plan and goals for patients/families as appropriate, • Provides supportive counseling and/or supportive therapy as well as ongoing social work services, • Collaborates and refers to appropriate agencies as required, • Aids in obtaining community services to patients, families and other caregivers, • Provides psycho education and advocacy for patients and families, • Assists staff, patients, families, and other caregivers to understand third party reimbursement, entitlements and community resources, • Initiates and maintains written and verbal communications according to VNS Home Care policy, • Performs established workflow procedures, • Maintains productivity sufficient to meet VNS Home Care goals, • Acts as liaison with other community agencies, • Participates in related VNS Home Care activities, e.g., utilization review, staff meetings, education programs, etc. Licenses and Certifications: Valid NYS ID or NYS driver’s license may be required as determined by operational needs. Education: Master's Degree in Social Work, Counseling, or related degree required Work Experience: Minimum one year of social work experience in a mental health or social service setting required Pay Range USD $31.94 - USD $38.20 /Hr. About Us VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us — we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

Job DescriptionBenefits: • 401(k) matching, • Competitive salary, • Flexible schedule, • Paid time off POSITION SUMMARY: Leads field staff in delivering exceptional client service, clinical care, quality, and adherence to policies and procedures. Accountable for internal case management and field staff evaluation and development. Conducts on-site initial and ongoing client assessments to identify needs and plan for services; monitors the care plan implementation to ensure achievement of desired outcomes; evaluates the performance and skills of the care providers to ensure appropriateness and compliance with standards; participates in orientation and education programs; and assumes clinical management responsibilities to ensure services provided are consistent with the mission of the organization. PRIMARY RESPONSIBILITIES: 1. Demonstrate and communicate the core values of CareTen, Inc., 2. Demonstrates high flexibility in working with service office team., 3. Maintain high client satisfaction scores., 4. Demonstrates expertise in conflict management skills., 5. Conduct client assessments and complete the care planning process including development, implementation, and updates to the clients individualized plan of care., 6. Responsible for clinical and client case management, 7. Provide clinical oversight to field staff, Certified Home Health Aides and LPNs., 9. Assists in agency evaluation activities., 10. Participates in state and national organizations, meetings. Seminars, workshops, and activities relating to the health professions and health care services, when appropriate., 11. Serves on and periodically reviews policies relevant to patient care with the Professional Advisory Committee., 12. Oversees all CQI and utilization review activities., 13. Oversees the implementation and evaluation of client care services inclusive of regulatory licensure and certification criteria and accreditation standards., 14. Be available at all times during operating hours and flexible schedule after hours and weekends., 15. Successfully oversee and manage all service and employment related content made to the office after normal business hours as necessary.

Job DescriptionRegistered Nurse – Nursing Home Surveyor / Complaint Investigator – New Rochelle, NY (#25141) Location: New Rochelle, NY Employment Type: Contract / Travel Hourly Rate: $45/hour About Greenlife Healthcare Staffing Greenlife Healthcare Staffing is a leading national recruitment agency committed to connecting skilled healthcare professionals with premier job opportunities. We partner with hospitals, nursing homes, clinics, and private practices to place candidates in roles that align with their career goals. Position Overview We are currently seeking an experienced Registered Nurse – Nursing Home Surveyor / Complaint Investigator for a Review Company based in New Rochelle, NY. In this dynamic contract/travel role, you will conduct regulatory compliance surveys, investigate complaints (including abuse/neglect), and help ensure safe, quality care in long-term care settings. Key Responsibilities • Conduct surveys, complaint investigations (including abuse/neglect), and surveillance in long-term care facilities, • Draft Statements of Deficiencies (SODs) using Principles of Documentation, • Evaluate compliance with Plans of Correction within required timelines, • Input findings into federal and state databases, • Participate in state monitoring during Immediate Jeopardy cases, • Attend staff meetings and provide testimony in administrative hearings as needed, • Comply with DOH schedules, policies, and procedures, • Travel to assigned facilities based on your work schedule Greenlife Healthcare Staffing Empowering Healthcare Professionals. Enriching Lives. Requirements Qualifications Education & Licensure: • Bachelor's degree in Nursing (preferred), • 2+ years of experience in utilization review, claims adjudication, medical review, fraud investigation, surveillance, or monitoring activities, • 3+ years of clinical or administrative nursing experience, • BSN + 2 years of clinical or administrative experience, • SMQT Certification preferred (must obtain within 12 months)

Job DescriptionOverview Essen Health Care is a growing community healthcare network that provides high quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State. Guided by a ‘population health’ model of care, Essen has five integrated clinical divisions offering services in primary & specialty offices, urgent care centers, and nursing homes, as well as house calls for home bound patients; all clinical services are also offered via telehealth. Our Care Management division supports patient-centered care through care coordination, complex care management and helping address health-related social needs. Founded in 1999, Essen provides care in all five boroughs of New York City, with a primary focus in the Bronx. Staffed by over 300 primary and specialty care physicians and advanced clinicians, Essen Health Care is one of the largest, most comprehensive private medical groups in New York City. Essen maintains a Clinical Information Services team that maintains our enterprise-wide electronic medical record system, data repository, clinical analytics and population health capabilities. Our Community Services teams creates and sustains relationship with community organizations and agencies and health plans. Essen is dedicated to ensuring the quality of care for all patients and has been designated ‘Level 3 Patient Centered Medical Home’ by the National Committee for Quality Assurance. Essen has won awards for its patient care innovations and recently launched Intention Health Ventures to develop and commercialize our technological innovations. Requirements Job Summary The Director of Population Health will provide strategic direction, leadership, and oversight of all population health initiatives within a large Integrated Delivery System (IDS). The incumbent will be responsible for the planning, development, and implementation of comprehensive population health, value-based care, and performance improvement programs. This includes oversight of HEDIS measures, care management, risk stratification, and utilization management to enhance care quality, promote cost savings, and improve patient outcomes. Responsibilities 1. Population Health Strategy & Program Development Develop and implement a system-wide strategy for population health management aligned with the organization’s mission, vision, and values. Lead the design and execution of innovative care delivery and value-based initiatives to support improved health outcomes and cost efficiency. Collaborate with senior leadership to set short- and long-term goals and performance metrics for population health, ensuring alignment with organizational strategy. 2. HEDIS Oversight and Quality Reporting Oversee the development, implementation, and monitoring of HEDIS-related processes to ensure the highest level of quality and compliance with regulatory requirements. Ensure accurate and timely data collection, reporting, and analysis for HEDIS, CMS Stars, and other quality measures. Identify performance gaps and drive improvement initiatives to enhance HEDIS performance across the organization. 3. Care Management and Coordination Provide leadership and direction for care management teams, including nurses, social workers, and care coordinators, to ensure effective care coordination for high-risk, high-cost patient populations. Implement risk stratification models and evidence-based care pathways to optimize patient outcomes and resource utilization. Ensure coordinated transitions of care, reduce readmissions, and improve patient engagement through strong interdepartmental collaboration. 4. Utilization Management Oversee utilization management activities, ensuring adherence to clinical guidelines and best practices to optimize care delivery and reduce unnecessary costs. Collaborate with providers, payers, and care teams to design and implement strategies to reduce avoidable hospital admissions, readmissions, and Emergency Department (ED) visits. Drive the utilization review process, establishing benchmarks and key performance indicators to monitor performance and identify improvement opportunities. 5. Data Analytics and Technology Integration Work closely with IT and Data Analytics teams to leverage population health management software and analytic tools for monitoring, trending, and forecasting clinical and financial outcomes. Utilize data-driven insights to identify population health trends, develop targeted interventions, and measure program effectiveness. Champion the use of electronic health records (EHR) to streamline care coordination, clinical documentation, and performance reporting. 6. Collaboration and Stakeholder Engagement Develop strong partnerships with physicians, clinical leaders, external healthcare organizations, community-based organizations, and payers to foster a culture of collaboration for population health initiatives. Serve as a subject matter expert for population health and value-based care, providing education, training, and guidance to internal stakeholders. Represent the organization in community forums, professional associations, and conferences to promote best practices in population health. 7. Regulatory Compliance and Accreditation Maintain current knowledge of federal, state, and local regulations and accreditation standards related to population health, quality, and value-based care. Ensure the organization’s compliance with regulatory requirements and accreditation standards (e.g., NCQA, CMS) related to population health and quality programs. Lead audits, accreditation processes, and quality improvement initiatives to meet and exceed compliance obligations. 8. Financial and Operational Management Develop and manage the budget for population health initiatives, ensuring cost-effectiveness and alignment with strategic priorities. Monitor financial performance and ROI for population health programs, implementing course corrections as needed. Identify and secure grants, partnerships, and other funding opportunities to support and expand population health efforts. 9. Leadership and Team Development Recruit, mentor, and retain high-performing population health and care management teams, fostering a culture of innovation and continuous learning. Provide leadership, coaching, and professional development opportunities to direct reports and cross-functional team members. Establish performance expectations and conduct regular performance evaluations, ensuring accountability and alignment with organizational goals. Qualifications 1. Education and Certification Master's degree in public health, Health Administration, Nursing, Business Administration, or a related field required. Clinical background (RN, MD/DO, or similar) preferred but not required. Certification in Population Health Management, Case Management, or Healthcare Quality (e.g., CPHQ, CCM) is highly desirable. 2.Experience: Minimum of 7–10 years of progressive leadership experience in population health, care management, or quality improvement within a large integrated delivery system or health plan. Demonstrated success in implementing and overseeing HEDIS, CMS Star Ratings, or other quality improvement programs. Proven track record of leveraging data analytics to drive strategic decisions, reduce costs, and improve clinical outcomes. Experience in leading interdisciplinary teams and managing complex, system-wide initiatives. 3. Knowledge and Skills: In-depth knowledge of population health principles, healthcare delivery models, and value-based care arrangements (e.g., ACOs, bundled payments, capitation). Familiarity with healthcare regulations, accrediting body standards (e.g., NCQA), and best practices in quality management and performance improvement. Exceptional analytical and problem-solving skills, with the ability to interpret complex data and implement evidence-based strategies. Strong leadership, communication, and interpersonal skills to inspire teamwork, influence stakeholders, and drive organizational change. Proficiency in Microsoft Office Suite, EHR systems, and population health management software. Benefits Equal Opportunity EmployerEssen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population

Travel Nurse RN - Case Manager, Utilization Review - $3,029 per week at Medical Solutions summary:.The Travel Nurse RN - Case Manager, Utilization Review role involves providing high-quality nursing care while managing cases for patients during a 13-week travel assignment.This position offers flexib

Job Description New Rochelle Region - Become SMQT Certified! $3,000 Sign-on Bonus Based in New Rochelle, the Nursing Home Surveyor/ Complaint Investigator will assist the New York State Department of Health (NYSDOH), Office of Aging and Long-Term Care, with surveillance and investigation activities related to nursing homes (long term care). These activities are mandated to evaluate facility performance and monitor the quality of care and services provided. In this role you will participate as a member of an interdisciplinary survey/investigation team to review allegations of abuse and neglect, perform surveillance activities/tasks at nursing homes (long term care)/Transitional Care Units (TCUs), and Adult Day Health Care Programs (ADHCP) to determine compliance with the requirements of participation; prepare written reports of investigative findings and prepare Statement of Deficiencies (SOD) within required time frame, using Principles of Documentation. participate in emergency surveys at Skilled Nursing Facilities (SNF’s); participate in State monitoring during Immediate Jeopardy situations; as well as other duties. This position is majority travel, will be onsite at facilities in Sullivan, Orange, Dutchess, Putnam, Rockland, Ulster and Westchester counties. Mileage and accommodation reimbursement provided. Non-travel days are based out of the NYSDOH New Rochelle office -OR- telecommuting, if approved. QUALIFICATIONS: • Demonstrate strong interpersonal skills with the ability to facilitate positive customer satisfaction in situations that are adverse or in controversy., • Ability to successfully work independently with minimal supervision, as well as in a team environment., • Excellent written and verbal skills with the ability to communicate professionally with co-workers, supervisors, providers, medical and administrative personnel, and residents/patients., • Ability to translate collected information into a clear, concise, legal, and defensible document., • Excellent investigative and analytical skills., • Strong computer skills with working knowledge of Microsoft office products, and the ability to learn new programs., • Ability to obtain Surveyor Minimum Qualifications Test (SMQT) certification within 12 months of employment, required., • If approved to work remotely, must have secure internet that meets the speed required to perform all work duties, must have workspace that provides privacy for all work-related calls, and must be able to secure all work-related items when not in use., • NYS Licensed and registered, Licensed Practical Nurse, graduate from an approved practical nursing program, required., • A minimum of two (2) years of experience in performing utilization review, claims adjudication, medical review, fraud investigation, surveillance, or monitoring activities, OR minimum of (2) years of clinical experience in a licensed health care facility, required. The salary range and/or hourly rate listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status.

Preferred Qualifications • Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non-clinical review/auditing experience. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer

Compass Healthcare Consulting & Placement is conducting a search for an experienced RN Administrator for Admissions, Intake & Outreach for a Hospital located in the Bronx, NY. New York State Registered Nurse and Masters Degree in Nursing is required. Opportunity for Clinical RN Administrative Leader for Facility Administrator role. Qualified candidates will have 10-15 years of Management experience, 5+ years experience as a Department Head and 3+ years as an RN Administrator or VP level within a Hospital setting. RN Administrator for Admissions, Intake & Outreach is responsible for overseeing the functions and activities associated with Community Outreach Services, Admitting, and Intake. Reports directly to the Vice President for Admitting, Intake and Outreach Services and maintains an open dialogue with the senior leadership of the hospital and referring partners. Responsibilities: • Continuously monitors and assesses the delivery of services provided by the Community Outreach, Admitting and Intake implementing changes when appropriate., • Acts as liaison between Hospital and referring institutions and providers., • Actively engages in the ongoing marketing of programs and services provided by the Hospital., • Works cooperatively with other departments, provider referrers and managed care organizations to facilitate the admission of patients to the various programs provided by the Hospital., • Interfaces with managed care organizations to facilitate reimbursement for services provided by the Hospital. Oversees the appeals process for those cases for which reimbursement has been denied., • Conducts interdepartmental meetings related to the quality and utilization of clinical services., • Serves on various Hospital committees as assigned., • Attends meetings and seminars as appropriate., • Ensures all related manuals are kept current., • Works within legal, ethical practice standards to his/her position as well as the Hospital's Code of Conduct. Complies with appropriate policies and procedures and brings potential compliance matters to the supervisor or compliance officer., • Oversees and participates in the budget process for his/her assigned departments., • Completes Introductory and Annual Performance Appraisals for all direct reports. Reviews Introductory and Annual Performance Appraisals for other assigned staff., • Oversees the interface with the Finance Office regarding pertinent insurance information, e.g. Medicare, Medicaid and Commercial Insurance., • Elicits recommendations regarding continuous improvement of patient safety from staff., • Encourages reporting of occurrences without fear of reprisal., • Participates in the development of recommendations for improvement in patient safety based on staff recommendations., • Participates in the implementation and monitoring of patient safety programs., • Maintains current knowledge of regulatory requirements which may impact on the delivery of patient services., • Integrates the services of the departments supervised into the day-to-day activities of the Hospital in support of its philosophy and mission., • Develops appropriate goals and objectives for departments supervised. QUALIFICATIONS: • Master of Nursing Degree required., • NYS unencumbered Registered Nurse License required., • Ten (10) to fifteen (15) years of management experience, five (5) of which must be at the department head level. Three (3) years’ experience as an Administrator or Vice President preferred., • Excellent interpersonal skills., • Ability to interface with all levels of personnel., • Excellent written and verbal communication skills., • Ability to analyze detailed statistical and other pertinent data., • Knowledge of and experience in Quality Assessment and Improvement, Utilization Review., • Ability to develop management systems to track data over time. Competitive Salary $190,000.00 - $210,000.00 and excellent Benefits Package! 401(k), Dental insurance, Employee assistance program, Employee discount, Free parking, Gym membership, Health insurance, Health savings account, Life insurance, Paid sick time, Paid time off, Retirement plan, Tuition reimbursement, Vision insurance Qualified Candidates Please Apply Now for Immediate Consideration!

Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. LPN / LVN licensure required Preferred Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and kn

Medical Solutions Direct Hire is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in Hartsdale, New York.Job Description & Requirements.Medical Solutions Direct Hire Job ID #942882.About Medical Solutions Direct Hire.At Medical Solutions, we’re people who care, he

Provides lead level clinical support to healthcare services team supporting one or more of the following functions: care management, utilization management, care transitions, long-term services and supports (LTSS), behavioral health, and other clinical programs, and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Provides level support to healthcare services department staff - devising/implementing delegation assignment strategies, facilitating healthcare services processes and communicating/coordinating activities. • Resolves issues and complaints that arise in day-to-day healthcare services operations and communicates escalation issues to healthcare services leadership. • Assists in training of healthcare services staff according to department standards, policies and procedures. • Maintains a minimal caseload to ensure adherence to appropriate guidelines and provide assistance to staff who have an ongoing member caseloads that may required additional support. • Collaborates with and keeps healthcare service leadership apprised of operational issues, staffing issues, system and program needs. • As a subject matter expert clinical lead, provides support, recommendations and education as appropriate to all other clinical and non-clinical staff. • Monitors healthcare services staff workload for adherence to policies, procedures, guidelines, and program specific requirements. • Actively participates in the department auditing program to review, communicate findings and identify opportunities for improved quality and compliance. • Shares quality and productivity scores with individual staff for awareness. • Provides feedback to healthcare services leadership on staff performance issues and consults with leadership on corrective action as necessary for performance improvement. • May collaborate with leadership to ensure the daily authorization reconciliation report (DARR) is run each work day and cases found non-compliant or missing compliance elements are remediated promptly. • May collaborate with leadership ensuring the care management monitoring tool (CMMT) is run every work day and cases are addressed to maintain health rid assessment (HRA) and care plan compliance. • Acts as liaison to both internal and external customers on behalf of both Molina and healthcare services department areas. • Local travel may be required (based upon state/contractual requirements). At least 4 years experience in health care, and at least 2 years of managed care experienced in utilization management • Registered Nurse (RN) ONLY if required by state contract, regulation or state board licensing mandates. Demonstrated knowledge of community resources. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and demonstrate self-motivation. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Microsoft Office suite/applicable software program(s) proficiency. Registered Nurse (RN). Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. • Prior experience overseeing Utilization Management processes, interQual, MCG guidelines, PEGA experience etc. Work schedule: full time daytime business hours, with some weekends and holiday support may be required. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $29.64 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Required Certifications- BLS, PRI (Patient Review Instrument) Certification, SCREEN Training Certification Unit Type- Case Management (Utilization Review) Trauma Level- 2 Charting System- Allscripts Case load: Floors typically have 33-40 patients; Most floors are split with 1 CM & 1 SW; Caseload: 17

Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. Preferred License, Certification, Association. Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare

JOB DESCRIPTION Job Summary Provides lead level clinical support to healthcare services team supporting one or more of the following functions: care management, utilization management, care transitions, long-term services and supports (LTSS), behavioral health, and other clinical programs, and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Provides level support to healthcare services department staff - devising/implementing delegation assignment strategies, facilitating healthcare services processes and communicating/coordinating activities. • Resolves issues and complaints that arise in day-to-day healthcare services operations and communicates escalation issues to healthcare services leadership. • Assists in training of healthcare services staff according to department standards, policies and procedures. • Maintains a minimal caseload to ensure adherence to appropriate guidelines and provide assistance to staff who have an ongoing member caseloads that may required additional support. • Collaborates with and keeps healthcare service leadership apprised of operational issues, staffing issues, system and program needs. • As a subject matter expert clinical lead, provides support, recommendations and education as appropriate to all other clinical and non-clinical staff. • Monitors healthcare services staff workload for adherence to policies, procedures, guidelines, and program specific requirements. • Actively participates in the department auditing program to review, communicate findings and identify opportunities for improved quality and compliance. • Shares quality and productivity scores with individual staff for awareness. • Provides feedback to healthcare services leadership on staff performance issues and consults with leadership on corrective action as necessary for performance improvement. • May collaborate with leadership to ensure the daily authorization reconciliation report (DARR) is run each work day and cases found non-compliant or missing compliance elements are remediated promptly. • May collaborate with leadership ensuring the care management monitoring tool (CMMT) is run every work day and cases are addressed to maintain health rid assessment (HRA) and care plan compliance. • Acts as liaison to both internal and external customers on behalf of both Molina and healthcare services department areas. • Maintains confidentiality, effective workplace relationships and adheres to company code of conduct. • Attends/participates in departmental, company-wide, and external committees, task forces, or work groups as assigned. groups as assigned. • Local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 4 years experience in health care, and at least 2 years of managed care experienced in utilization management • Registered Nurse (RN) ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • Demonstrated knowledge of community resources. • Proactive and detail-oriented. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and demonstrate self-motivation. • Responsive in all forms of communication. • Ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. • Medicaid/Medicare population experience. • Clinical experience. Prior experience overseeing Utilization Management processes, interQual, MCG guidelines, PEGA experience etc. Work schedule: full time daytime business hours, with some weekends and holiday support may be required. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $29.05 - $56.64 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job DescriptionCompany Description Veolia in North America is the top-ranked environmental company in the United States for three consecutive years, and the country’s largest private water operator and technology provider as well as hazardous waste and pollution treatment leader. It offers a full spectrum of water, waste, and energy management services, including water and wastewater treatment, commercial and hazardous waste collection and disposal, energy consulting and resource recovery. Veolia helps commercial, industrial, healthcare, higher education and municipality customers throughout North America. Headquartered in Boston, Veolia has more than 10,000 employees working at more than 350 locations across North America. Job Description Position Purpose: The Manager of Meter Operations plays a crucial role in upholding Veolia’s commitment to customer experience. This position involves providing leadership and direct oversight to the Meter Operations organization within the customer operations division. The incumbent is expected to optimize performance in planning and scheduling, meter reading, regulatory meter change compliance, collections, management of large and strategic meters, backflow compliance, and meter data analytics/collection for over 200,000 meter connections. Primary Duties/Responsibilities: • Lead employees involved in the installation, maintenance, and reading of the Company's residential, commercial, and industrial metering systems. Performance management of the team will be conducted using defined key performance indicators and other relevant metrics., • Directs the activities of the Supervisor(s) who are responsible for overseeing daily department activities including the hydrant rental meter program, meter installations, meter changes, meter reading, high bill investigations, testing, maintaining the Advanced Meter Infrastructure and repairing meters., • Responsible for tracking and reporting all aspects of new service orders from the time it is released to the Meter Services Department up to and including ensuring the first bill has been generated in the billing system., • Manages the meter test benches certifications and testing activities, including the organization and utilization of meter testing data to meet regulatory requirements and drive decisions related to the company’s meter assets. Provide yearly compliance reporting to the utility regulators., • Work cross-functionally with other teams across Veolia to ensure optimal management of the meter systems assets, effective appointment scheduling and service order generation, and successful account inquiries/troubleshooting., • Prioritize, plan and implement meter field services and meter data policies and procedures to ensure alignment with best-in-class standards., • Performs ordering, approving, and accurate inventory procedures for department materials., • Perform field inspections periodically from a quality control and safety (managerial safety visit) aspect for all meter related field work., • Repairing/reprogramming the automatic meter reading system as needed., • Investigates and resolves routine problems with plumbers, contractors and customers., • Develops and monitors meter reading schedules to ensure all cycles are read timely and within appropriate bill windows in the company’s billing system, while minimizing estimated reads., • The incumbent ensures that all activities are carried out efficiently and in accordance with standards and regulations set forth by management and our utility regulators., • Consults with the Supervisor(s) regarding department operations and objectives, personally resolving significant or complex problems/escalations and when required, personally inspecting department projects. Working with the supervisor, the incumbent develops and closely monitors workforce efficiency usage plans on a monthly and yearly basis., • Works closely with other departments across Veolia to ensure all operational technologies and processes are in place and functioning appropriately., • Manages and holds accountable outside contractors hired to install meters for compliance or automatic meter reading devices., • The Manager prepares budgets and submits periodic reports on a daily, monthly, quarterly and yearly basis., • Ensures that proper attention is given to meter installations requiring special instructions. The incumbent may also become personally involved in situations where service has been interrupted to major accounts or situations affecting a substantial amount of customers., • Responsible for maintaining an adequate inventory of small and large domestic meters, installations, changing, repairing and testing of large meters, servicing of fire meters and preparation and submission of required reports., • Responsible for the meter aged compliance program and the large/strategic meter change out programs. These programs require the changing of meters of certain sizes at specified time intervals., • Ensures that all staff receive adequate training in job skills and safety. Meets monthly with staff to ensure adequate communication and alignment in the meter department., • In partnership with the Revenue Assurance team, the incumbent remains abreast of new products, equipment and techniques in the meter field and makes recommendations for updating or improving existing equipment. In this regard, the incumbent meets with representatives from various manufacturers and other water companies., • Oversees a team that manages emergency field visits after hours. May be required to go out in the field to support and resolve emergency situations., • Manage and review all meter related reporting and metrics., • Maintains understanding of the cross-connection control program, to ensure backflow devices for required customer meter installations., • Works closely with the new business department to ensure proper installation of new sets and sees the process through from start to finish., • Assist and provide support, testing and materials to other meter departments across the New Jersey division., • Collaborates with transportation, system maintenance, engineering and construction departments to align operations and coordinate special projects, • Responsible for deploying initiatives that help reduce non-revenue water., • Some travel will be required.Qualifications Education/Experience/Background: • B.S. degree in business or related field, MBA preferred., • 10+ years of experience leading service operations., • Knowledge of meter changes, plumbing, operations, repair as well as backflow prevention devices preferred., • Excellent interpersonal and organizational skills, • Demonstrated ability to work both autonomously and as part of a team in a fast-paced, matrixed environment., • Working knowledge of workforce management tools and technology., • Working knowledge of customer information systems (CIS)., • Working knowledge of Google products – Sheets, Docs, Gmail, - Power BI or similar tools., • Strong analytical skills, expert-level written and verbal communication skills, and attention to detail., • Ability to synthesize data and translate insight into relevant usable actionable strategic and tactical recommendations., • Must be able to lift up to 50 lbs., • Must be able to climb, walk, kneel, sit and stand. Additional Information Pay Range: $110000 to $115000 annually Benefits: Veolia’s comprehensive benefits package includes paid time off policies, as well as health, dental and vision insurance. In addition, employees are also entitled to participate in an employer sponsored 401(k) plan, to save for retirement. Pay and benefits for employees represented by a union are outlined in their collective bargaining agreement. Sick leave – 56 hours; Observed Holidays – 11 days; Vacation – Flexible Time Off Eligible for up to 15% Annual Performance Bonus. We are an Equal Opportunity Employer! All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. Disclaimer: The salary, other compensation, and benefits information is accurate as of the date of this posting. The Company reserves the right to modify this information at any time, subject to applicable law.

Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing 40 hours per week Shift: 8 hours, days Employment Type: Staff Medical Solutions Direct Hire Job ID 942882. Medical Solutions Direct Hire is seeking a Registered Nurse (RN) Case Manager, Uti

Medical Solutions Direct Hire is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in White Plains, New York.

Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Bronx, New York. Posted job title: Case Management (Utilization Review). Travel Nurse, Case Manager, Utilization Review, Healthcare, RN, Nursing Jobs, Medical Solutions, Flexible Schedule, Hig

Prescription refills: Review chart, scheduled appointment if needed send to provider for authorization.

Host Healthcare is seeking a local contract nurse RN Radiology for a local contract nursing job in Hackensack, New Jersey.Job Description & Requirements.Host Healthcare Job ID #La1fVJ0000075OFNYA2.Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free sti

Jonathan David! We are seeking a Per Diem Registered Nurse (RN) to join our team in the OBS Post Op.Jonathan David has partnered with Allied Digestive Health which is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throug

MedPro Healthcare Staffing is seeking a travel nurse RN Cardiac Cath Lab for a travel nursing job in Hackensack, New Jersey.Job Description & Requirements.Joint Commission-certified staffing agency, is seeking a quality Cath Lab Registered Nurse (RN) for a travel assignment with one of our top healt

Prime Staffing is seeking a travel nurse RN System Float ICU - Intensive Care Unit for a travel nursing job in Hackensack, New Jersey.Job Description & Requirements.Prime Staffing Job ID #34162706.Pay package is based on 12 hour shifts and 36.Posted job title: RN:ICU,07:00:00-19:30:00.At Prime Staff

Host Healthcare is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Hackensack, New Jersey.Job Description & Requirements.Host Healthcare Job ID #a1fVJ000006uzOjYAI.Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free sti

Prime Staffing is seeking a travel nurse RN Cardiac Cath Lab for a travel nursing job in Hackensack, New Jersey.Job Description & Requirements.Cardiac Catheterization Lab or similar critical care setting.Active State or Compact RN License.Proficient in pre-, intra-, and post-procedure care; familiar

Host Healthcare is seeking a local contract nurse RN ED - Emergency Department for a local contract nursing job in Hackensack, New Jersey.Job Description & Requirements.Host Healthcare Job ID #La1fVJ000006uzgTYAQ.Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation)

TRS Healthcare is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Westwood, New Jersey.Job Description & Requirements.TRS Healthcare Job ID #13683720.Pay package is based on 12 hour shifts and 48 hours per week (subject to confirmation) with tax-free stipend amount to

Prescription refills: Review chart, scheduled appointment if needed send to provider for authorization.

We’re looking for enthusiastic, self-driven, individuals to assist existing and prospective clients within our organization.This position will work with multiple clients throughout the day providing outstanding service and product knowledge.Distributes all benefit enrollment materials and

Jonathan David! We are seeking a Per Diem Registered Nurse (RN) to join our team in the OBS Post Op.Jonathan David has partnered with Allied Digestive Health which is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throug

We’re looking for enthusiastic, self-driven, individuals to assist existing and prospective clients within our organization.This position will work with multiple clients throughout the day providing outstanding service and product knowledge.Distributes all benefit enrollment materials and

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United States.

We’re looking for enthusiastic, self-driven, individuals to assist existing and prospective clients within our organization.This position will work with multiple clients throughout the day providing outstanding service and product knowledge.Distributes all benefit enrollment materials and

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United States.

We’re looking for enthusiastic, self-driven, individuals to assist existing and prospective clients within our organization.This position will work with multiple clients throughout the day providing outstanding service and product knowledge.Distributes all benefit enrollment materials and

Job Title: Registered Nurse Department: Med/Surg Location: Newark Wayne Hospital Hours Per Week: 36 hours per week Schedule: Evening (7am-7pm), rotating weekends and holidays SUMMARY: As a Registered Nurse (RN), you’re the engine and the heart of patient care at Rochester Regional Health.You mak

Maintains mandatory certification, and competency including but not limited to annual review, BLS, etc. Reviews plan of care daily and/or updates it to reflect current status of patient. Contributes to growth and development of staff and students through participation in peer review, mentor relation

Job Title: Registered Nurse (R.Emergency Department Department: Emergency Department Location: Newark Wayne Hospital Hour per week: Part-time (24 hours per week) Schedule: Day/Evening/Night, every other Weekend/Holiday SUMMARY As a Registered Nurse (RN), you are the engine and the heart of pat

Montefiore Medical Center is seeking a Registered Nurse (RN) ED - Emergency Department for a nursing job in Englewood Cliffs, New Jersey.Job Description & Requirements.For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift diff

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United States.

Montefiore Medical Center is seeking a Registered Nurse (RN) ED - Emergency Department for a nursing job in Bronx, New York.Job Description & Requirements.For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, exp

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United States.

Montefiore Medical Center is seeking a Registered Nurse (RN) CCU - Coronary Care Level I for a nursing job in Bronx, New York.Job Description & Requirements.For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, e

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United States.

Montefiore Medical Center is seeking a Registered Nurse (RN) ED - Emergency Department for a nursing job in Edgewater, New Jersey.Job Description & Requirements.For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differentia

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United States.

Montefiore Medical Center is seeking a Registered Nurse (RN) ED - Emergency Department for a nursing job in Edgewater, New Jersey.Job Description & Requirements.For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differentia

Job Title: Registered Nurse Department: Med/Surg Location: Newark Wayne Hospital Hours Per Week: Part-time (24 hours per week) Schedule: A mix between Day/Evening (7am-7pm) and Evening/Night (7pm-7am), rotating weekends and holidays SUMMARY: As a Registered Nurse (RN), you’re the engine and the