• Perinatal & Early Childhood Mental Health…

    City of New York (New York, NY)
    …integration, data management, stakeholder collaboration, and capacity building to enhance behavioral health services for pregnant and parenting caregivers. Job ... tools. Program Strategy & Service Expansion - Lead the expansion of behavioral health services for pregnant and parenting caregivers, integrating substance… more
    City of New York (10/21/25)
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  • Senior Decision Support Consultant

    Highmark Health (Albany, NY)
    …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... units that may assist in the resolution of issues or problems. + Access, review , utilize, contribute content to and participate in the maintenance of the shared… more
    Highmark Health (11/14/25)
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  • Senior Intake Coordinator

    Highmark Health (Buffalo, NY)
    …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (12/02/25)
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  • Intake Coordinator

    Highmark Health (Buffalo, NY)
    …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses ... and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (12/02/25)
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  • Associate Psychologist

    New York State Civil Service (Valatie, NY)
    …experimental psychology, research psychology, industrial psychology, organizational psychology, utilization review , guidance counseling, etc. Additional Comments ... homes, as well as discipline-specific projects, including assisting with enhancing utilization of electronic health records, participation in relevant committees… more
    New York State Civil Service (12/12/25)
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  • Psychologist 1/2

    New York State Civil Service (NY)
    …in experimental psychology, research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance ... With Developmental Disabilities, Office for Title Psychologist 1/2 Occupational Category Health Care, Human/Social Services Salary Grade 21 Bargaining Unit PS&T -… more
    New York State Civil Service (10/16/25)
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  • Payment Integrity Clinician

    Highmark Health (Albany, NY)
    …of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member ... Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a ...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
    Highmark Health (11/14/25)
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  • Medical Director, Medical Management

    Highmark Health (Albany, NY)
    …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
    Highmark Health (11/21/25)
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  • Case Manager RN - Per Diem

    Nuvance Health (Carmel, NY)
    …essential services a community needs from their local hospital, including Emergency and Behavioral Health Services. Our accolades include: * The Leapfrog Group - ... *Description* *Intro:* At Nuvance Health , we enjoy the benefits of a two-state...Program (MBSAQIP) * Robotic Center of Excellence - Surgical Review Corporation (SRC) At Putnam Hospital, our team members… more
    Nuvance Health (11/18/25)
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  • Dental Network Service Representative

    Highmark Health (Albany, NY)
    …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
    Highmark Health (11/14/25)
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