• Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    …conventions and insurance / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG denial management ... successfully execute, support, implement, and monitor the DRG and Utilization Management Clinical Denial teams Work Plan...5 years of experience in a large, complex acute care setting in a supervisory / administrative role required.… more
    Kaleida Health (06/19/25)
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  • Care Review Clinician, PA (RN)…

    Molina Healthcare (Yonkers, NY)
    …Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
    Molina Healthcare (07/17/25)
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  • System Vice Chair Clinical Operations…

    Mount Sinai Health System (New York, NY)
    …bed utilization , reduce length of stay, streamline transitions of care , and enhance discharge planning. **Collaborative Review of Existing Initiatives** ... leaders to optimize hospital medicine, consultative services, and team-based inpatient care delivery models. Ensure clinical standardization across specialties.… more
    Mount Sinai Health System (08/08/25)
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  • Clinical Program Manager - Clinical

    Mount Sinai Health System (New York, NY)
    …a day functions of health-system throughput, transfer center, quality, and delivery of care . The Clinical Program Manager, Clinical Command Center ... planners, admitting staff, Emergency Department, Perioperative Services, Transfer Center and clinical and administrative staff on the patient care units… more
    Mount Sinai Health System (08/09/25)
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  • Clinical Director Of Behavioral Health…

    Villa of Hope (Rochester, NY)
    …Ensures full participation of Tuckahoe staff in compliance, quality assurance, utilization review , and program evaluation activities. Maintains operating ... related services they may enroll in at Villa of Hope (Clinic, Health Homes/ Care Management, etc.). The Clinical Director operates these programs in alignment… more
    Villa of Hope (07/02/25)
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  • Clinical Laboratory Technologist Shift…

    Stony Brook University (Stony Brook, NY)
    Clinical Laboratory Technologist Shift Supervisor - Immunology **Position Summary** At Stony Brook Medicine, a TH Clinical Laboratory Technologist I/Shift ... with all regulatory standards. Qualified candidates will demonstrate superior patient care and possess outstanding communication skills while adhering to our high… more
    Stony Brook University (05/21/25)
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  • Mental Health Program Specialist 3…

    New York State Civil Service (Albany, NY)
    …working with children and/or adolescents with mental illness, as well as utilization management experience, including familiarity with the review of medical ... Agency Mental Health, Office of Title Mental Health Program Specialist 3 ( Clinical ), Central Office; Occupational Category Other Professional Careers Salary Grade 25… more
    New York State Civil Service (08/15/25)
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  • Physician Advisor

    WMCHealth (Valhalla, NY)
    … and resource management areas of Integrated Case Management including mentoring/coaching care coordinators, utilization review staff and social workers. ... Physician Services PC City/State: Valhalla, NY Category: Physicians Department: Clinical Care Mgmt- WMC Health Union: No... guidelines and parameters to assure consistency in the review process to reflect appropriate utilization and… more
    WMCHealth (05/22/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Jamaica, NY)
    …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all… more
    Fresenius Medical Center (07/17/25)
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  • Clinical Laboratory Technologist -Blood…

    Stony Brook University (Stony Brook, NY)
    Clinical Laboratory Technologist -Blood Bank - Per Diem **Position Summary** At Stony Brook Medicine, a **TH Clinical Laboratory Technologist** is a valuable ... member of our team, who provides clinical services to our patient population. Qualified candidates will demonstrate superior patient care and possess outstanding… more
    Stony Brook University (05/31/25)
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