• Pharmacist, Utilization Management…

    Molina Healthcare (Yonkers, NY)
    … (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/ Management staff work to ensure that Molina members...initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and… more
    Molina Healthcare (09/25/25)
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  • Utilization Management…

    Elevance Health (Latham, NY)
    ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (09/25/25)
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  • Insurance Specialist-Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
    Mount Sinai Health System (07/23/25)
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  • RN/Case Manager -MSH-Case Management…

    Mount Sinai Health System (New York, NY)
    **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case Manager (CM) will be responsible for all aspects of case management for an ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management … more
    Mount Sinai Health System (09/23/25)
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  • RN Case Manager - Case Management…

    Guthrie (Corning, NY)
    …and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates ... Summary: In collaboration with the interdisciplinary healthcare team, the Case Manager will coordinate the flow of services throughout the patient's hospitalization… more
    Guthrie (09/23/25)
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  • Testing Center of Excellence Manager - Epic…

    Northwell Health (Melville, NY)
    **Req Number** 164399 Job Description The Epic Testing Manager will be working closely with his/her respective teams (onsite/offshore), the epic core and adjacent ... multi-facility Healthcare settings. The candidate should have significant experience in management of multiple teams of testers and develops comprehensive test… more
    Northwell Health (09/25/25)
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  • Manager , Healthcare Services

    Molina Healthcare (Buffalo, NY)
    …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and...years in one or more of the following areas: utilization management , case management , care… more
    Molina Healthcare (09/27/25)
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  • Account Manager Senior ENT

    City National Bank (New York, NY)
    …clients. Participates in customer call program either independently or with Relationship Manager . Prepares call reports for management . * Provides assistance and ... *ACCOUNT MANAGER SENIOR ENT* WHAT IS THE OPPORTUNITY? This...Resolves problems, answers questions related to customer accounts and utilization of bank products and services. Works with customers… more
    City National Bank (09/21/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …provided by the Case Manager include, but are not limited to, utilization review, case management , care transition, collaboration with physicians and social ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management ...discharge planning guidelines and departmental/organizational policies and processes + Utilization Management : + Ensures order in chart/EMR… more
    Ellis Medicine (09/11/25)
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  • Manager - Technical Project…

    American Express (New York, NY)
    …+ Leads Program Increment (PI) planning meetings with senior leadership, product management , and delivery teams to ensure strategic alignment and readiness + Mentors ... of features for future PI planning sessions + Develops risk management plans, conducts regular risk assessments, and implements mitigation strategies to… more
    American Express (09/20/25)
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