• Denials Prevention Specialist, Clinician PRN

    Datavant (Albany, NY)
    …BA or BS in Nursing, experience preferred to perform + Minimum Experience: 3 to 5 years acute care experience + 2 years Health Plan or Acute Care ... medical necessity and necessity of continued stay in the inpatient patient care setting and/or discharge to...UR/CM + Preferred Experience: 5 years acute care or health plan UR/CM with 1 year ICU/ER… more
    Datavant (11/12/25)
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  • Vice President Revenue Cycle

    Catholic Health (Buffalo, NY)
    …position will oversee the following revenue cycle operations and performance: + Catholic Health Acute Care Facilities o Mercy Hospital of Buffalo o Sisters of ... cycle: + Patient Access + Health Information Management + Coding and Coding Education + Inpatient...Cash Processing, Contract Implementation, Regulatory Compliance, Provision for Charity Care and Bad Debt Processes spanning all the entities… more
    Catholic Health (11/12/25)
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  • Medical Director - Nat'l UM IP (4x10 hr)

    Humana (Albany, NY)
    …participation in care management. The clinical scenarios predominantly arise from inpatient or post- acute care environments. Has discussions with ... or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of...case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. **Preferred… more
    Humana (11/07/25)
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  • PCO Medical Director- UM - Full Time

    CenterWell (Albany, NY)
    … care facilitation with hospitals. The clinical scenarios predominantly arise from inpatient or post- acute care environments. There are discussions with ... experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type… more
    CenterWell (11/06/25)
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  • Medical Director - Medicaid N. Central

    Humana (Albany, NY)
    …participation in care management. The clinical scenarios arise from outpatient, inpatient or post- acute care environments. The Medical Director will ... experience post residency or fellowship, which preferably includes some experience in an inpatient and/or outpatient environment and/or related to care of a… more
    Humana (10/25/25)
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  • Physician Assistant, Surgical - Cardiac Surgery

    Albany Medical Center (Albany, NY)
    …our high-performing Cardiothoracic Surgery team, with additional responsibilities across inpatient care and multidisciplinary coordination. This full-time ... based on current clinical guidelines. + Participate in the care of patients on inpatient consult services,...of 2 years' experience in a surgical or hospital-based acute care setting (CT Surgery experience strongly… more
    Albany Medical Center (11/11/25)
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  • Physician Asst-Surgical - Cardiac Surgery

    Albany Medical Center (Albany, NY)
    …our high-performing Cardiothoracic Surgery team, with additional responsibilities across inpatient care and multidisciplinary coordination. This full-time ... therapies based on current clinical guidelines.* Participate in the care of patients on inpatient consult services,...of 2 years' experience in a surgical or hospital-based acute care setting (CT Surgery experience strongly… more
    Albany Medical Center (10/02/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …In addition, the UR nurse is responsible for completing inpatient level of care reviews, post- acute care initial and concurrent reviews for acute ... Associates degree required. + Minimum two (2) years of acute care experience is required as a...years Utilization Management experience is preferred. + Knowledge of coding /claims processing is preferred. + Experience working with Microsoft… more
    CDPHP (09/23/25)
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  • Director, Clinical Documentation Improvement…

    Rochester Regional Health (Rochester, NY)
    …Clinical Documentation Specialist (CCDS) within two years of hire. + Minimum five years acute care experience required. + RN (must be licensed in the state ... educational classes. + Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures CDI staffs are appropriately educated. +… more
    Rochester Regional Health (10/04/25)
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  • Medical Director - Claims Mgmt (Remote)

    Humana (Albany, NY)
    …experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type ... management, case management, discharge planning and/or home health or post- acute services such as inpatient rehabilitation. **Preferred Qualifications**… more
    Humana (11/01/25)
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