• AVP, Utilization Review & Pharmacy

    Zurich NA (Albany, NY)
    …rehab field + Experience in development and implementation of cost containment programs + Case management , utilization review , catastrophic or disability ... AVP, Utilization Review & Pharmacy 123092 Zurich...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
    Zurich NA (05/22/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with ... years of inpatient experience in a hospital environment preferred. + Previous case management , utilization review , and discharge planning experience… more
    Ellis Medicine (04/25/25)
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  • Workers Compensation, Nurse Case Manager

    Brighton Health Plan Solutions, LLC (New York, NY)
    About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and Workers' ... coordinate medical and disability services for timely return to work. + Provides case management , utilization review , continued stay reviews, and based… more
    Brighton Health Plan Solutions, LLC (03/20/25)
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  • RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    Provides health care services regarding admissions, case management , discharge planning and utilization review . Responsibilites: Reviews admissions and ... retrospective medical necessity and/or compliance with reimburesement policy criteria. Provides case management and/or consultation for complex cases. Assists… more
    Guthrie (04/05/25)
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  • Insurance Specialist - Samaritan Hospital - PD…

    Trinity Health (Troy, NY)
    …completed a college level course in medical terminology. + One year of case management or utilization review /billing or coding experience. + One year of ... records/billing or healthcare related field + One year of case management or utilization review , billing, or coding experience Please be aware for the… more
    Trinity Health (03/15/25)
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  • Medical Director, Safety Net Population

    Excellus BlueCross BlueShield (Rochester, NY)
    …and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of requests ... I Qualifications) + Minimum 2-3 years of experience in medical management , utilization review and case management . + Knowledge of managed care… more
    Excellus BlueCross BlueShield (05/15/25)
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  • RN Case Manager - Case

    Mohawk Valley Health System (Utica, NY)
    …and regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review / case management experience or social ... RN Case Manager - Case Management - per diem Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of Case more
    Mohawk Valley Health System (05/13/25)
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  • Assistant Vice President

    Sedgwick (Albany, NY)
    …to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business ... lines; and to provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction through the… more
    Sedgwick (05/23/25)
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  • RN-Education Spec-Clin Center for Learning…

    Albany Medical Center (Albany, NY)
    …* Experience in the field of Clinical Social Work or Nursing with experience in Case Management , Utilization Review and Discharge Planning. * BLS ... Demonstrate principles of conflict resolution and promote consensus building.* Represents Case Management /Social Work at organizational committee meetings as… more
    Albany Medical Center (03/04/25)
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  • Consultant, Nurse Disability

    Lincoln Financial (Albany, NY)
    …Orthopedics, Coronary Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like to ... will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
    Lincoln Financial (04/30/25)
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