• Quality Improvement Specialist- RN

    WMCHealth (Poughkeepsie, NY)
    …lawsuit, etc.) and alerts the department director, medical staff leadership, and claims manager . + Conducts special studies in collaboration with medical ... data analysis, and graphical display. Responsibilities related to risk management + Review incident reports on a daily basis....etc.) and alerts the department director, administration, and the claims manager . Initiates a more thorough review… more
    WMCHealth (11/01/25)
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  • LTSS Service Coordinator - Community RN (UAS)

    Elevance Health (New York, NY)
    …individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management , or similar role; or any combination of ... Service Coordinator - RN Clinician** is responsible for overall management of member's case within the scope...+ May also assist in problem solving with providers, claims or service issues. + Directs and/or supervises the… more
    Elevance Health (10/04/25)
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  • Medical Director (NV)

    Molina Healthcare (Yonkers, NY)
    …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) ... health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure… more
    Molina Healthcare (11/21/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Buffalo, NY)
    …(CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional ... likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical knowledge, knowledge… more
    Molina Healthcare (11/14/25)
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  • ALB - Airport Operations Supervisor

    Albany International Airport (Albany, NY)
    …equipment for use of management staff. + In the absence of senior management , this position will represent the Airport Manager in routine operational matters ... POSITION: Airport Operations Supervisor REPORTS TO: Operations Manager LOCATION: ALB AIRPORT: Albany International Airport SUMMARY Assists the Operations Manager … more
    Albany International Airport (11/22/25)
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  • Administrator - OB/GYN, Department of Obstetrics…

    BronxCare Health System (Bronx, NY)
    …HIV Family Clinic, the Labor and Delivery Unit, the Women's Center, CAPC Prenatal, Case Management and Intake Sites and the Medical Records Department, etc. - ... of Ob/Gyn HIV Care, supervises the MIRIAD Research Assistant. - Directly supervises Case Management /Social Staff on HIV Grant funding in collaboration with the… more
    BronxCare Health System (09/13/25)
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  • Surveillance Investigator

    The Robison Group (Albany, NY)
    …FOR GROWTH WITHIN THE COMPANY INCLUDE: SIU work, Field Supervisor, Field Operations Manager , Case Management , etc. Department Surveillance Employment Type ... the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil… more
    The Robison Group (10/16/25)
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  • Lead Investigator, Special Investigative…

    Molina Healthcare (Rochester, NY)
    …to leading a team of investigators and analysts, the Team Lead will ensure the Manager is aware of any major case developments, and ensure cases are being ... **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead...utilization by providers and recipients. The position will review claims data, medical records, and billing data from all… more
    Molina Healthcare (11/21/25)
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  • Paralegal Specialist

    HANAC, Inc. (Astoria, NY)
    …the educational requirements. + 1-2 years of experience working in legal applications and case management databases is required. + The ability to work on ... Record work time on ADP and report to the manager any issue related to attendance. + Open contacts...any relevant material & prepare trial notebooks, affidavits, motions, claims , forms, and communications for client`s cases. + Attend… more
    HANAC, Inc. (11/09/25)
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  • Program Director

    Project Renewal, Inc. (Brooklyn, NY)
    …and diagnosed with substance use disorders. Our comprehensive services include case management , individual and group counseling, recreational activities, and ... the following activities: + O verall responsibility for day-to-day management of a 134-bed shelter for homeless men, with...federal, state and city audits as well as any claims or lawsuits filed by clients and staff. +… more
    Project Renewal, Inc. (11/07/25)
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