• Database Manager

    City of New York (New York, NY)
    …including a variety of client eligibility and recertification systems, case management systems, housing systems, employment/work engagement services, revenue ... (ITS) is recruiting for one (1) IT Project Specialist, to function as Database Manager , who will; - Manage AWS RDS environments running the Oracle engine, which… more
    City of New York (11/07/25)
    - Related Jobs

  • Registered Nurse Clinical Care Coordinator

    Northwell Health (Bay Shore, NY)
    …follow up and action. + * Acts as a liaison with patient's insurance carrier ( case manager , utilization reviewer) to coordinate post hospital services and ... to the Hospital. Job Responsibility + * Performs concurrent review on all patients and share all problematic cases...as required. + * Participates in the maintenance of Utilization Management, Discharge Planning and Case Management… more
    Northwell Health (11/18/25)
    - Related Jobs

  • Medical Director - Medical Oncology

    Elevance Health (New York, NY)
    …to members and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology ... regimens and supportive care. + Perform physician-level case review , following initial nurse review...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
    Elevance Health (11/14/25)
    - Related Jobs

  • Transplant Care Nurse (Remote)

    Highmark Health (Albany, NY)
    …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans… more
    Highmark Health (11/06/25)
    - Related Jobs

  • Medical Director, Behavioral Health (NE)

    Molina Healthcare (Albany, NY)
    …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
    Molina Healthcare (11/09/25)
    - Related Jobs

  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …necessity in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay ... 3 years acute hospital care experience not required. PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience preferred. + Bachelor's… more
    Rochester Regional Health (10/24/25)
    - Related Jobs

  • Medical Management Specialist I

    Elevance Health (Latham, NY)
    …appropriate area to refer or assign case ( utilization management, case management, QI, Med Review ). + Provides information regarding network providers or ... clinical information regarding case and determines...and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation… more
    Elevance Health (11/15/25)
    - Related Jobs

  • Medical Services Coordination Specialist I/II/III

    Excellus BlueCross BlueShield (Rochester, NY)
    …federal regulatory mandates related to the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and ... as needed, at the time of the annual performance review + Non-care manager support staff duties...daily and as needed basis for department related metrics: case and review timeliness, workflow volumes, referrals… more
    Excellus BlueCross BlueShield (10/21/25)
    - Related Jobs

  • PCO Medical Director- UM - Full Time

    CenterWell (Albany, NY)
    …Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an assigned ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
    CenterWell (11/06/25)
    - Related Jobs

  • Medical Management Nurse

    Elevance Health (Latham, NY)
    …of 4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of ... by law. The **Medical Management Nurse** is responsible for review of the most complex or challenging cases that...skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has… more
    Elevance Health (11/18/25)
    - Related Jobs