• Medical Director , Post-Acute Care…

    MVP Health Care (Tarrytown, NY)
    …thinking and continuous improvement. To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management ** to join #TeamMVP. If ... reviews, continued stay requests, and handling first-level appeals. + Collaborate with Utilization Management , Case Management , Quality Department and other… more
    MVP Health Care (08/04/25)
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  • Medical Director - Florida

    Humana (Albany, NY)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/29/25)
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  • Medical Director - South Central

    Humana (Albany, NY)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/11/25)
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  • Medical Director - NorthEast Region

    Humana (Albany, NY)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/25/25)
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  • Community is Everything Help LEAD Yours!-LCSW…

    Samaritan Daytop Village (Queens, NY)
    …and agency administration. The Program Director will be responsible for census/ utilization management and quality assurance. What You Will Do + Supervise ... Community is Everything Help LEAD Yours! LCSW Program Director -OASAS Facility Staten Island Social Workers, psychotherapists and mental health professionals can work… more
    Samaritan Daytop Village (08/03/25)
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  • Senior Medical Director (Medicare)

    Molina Healthcare (Yonkers, NY)
    …experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization… more
    Molina Healthcare (06/13/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (08/02/25)
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  • Corporate Practice Manager

    Akin Gump Strauss Hauer & Feld LLP (New York, NY)
    …arrivals and transitions. Talent Management & Development + Work with Director to support workload management / utilization through ongoing communication ... Corporate Practice Manager in our Client Value & Practice Management department, reporting directly to the Director ...with partners, associates and staffing personnel. Review utilization reports and raise productivity issues as appropriate. +… more
    Akin Gump Strauss Hauer & Feld LLP (06/25/25)
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  • Director of Case Management

    Stony Brook University (Stony Brook, NY)
    …including managing Case Management leadership and staff functions related to case management and utilization management activities. + Manage and mentor a ... Director of Case Management **Position Summary**...design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead… more
    Stony Brook University (08/08/25)
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  • Associate Director of Program…

    CUNY (New York, NY)
    Associate Director of Program Management , ASAP|ACE **POSITION DETAILS** Founded in 2007, CUNY's Accelerated Study in Associate Programs (ASAP) is a comprehensive ... ASAP|ACE Director for Data Strategies and Evaluation, the ASAP|ACE Associate Director for Program Management is responsible for executing key program… more
    CUNY (07/30/25)
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