• Clinical Appeals Nurse (RN)

    Molina Healthcare (Syracuse, NY)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and… more
    Molina Healthcare (05/16/25)
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  • Director Physician Advisor

    Catholic Health Services (Melville, NY)
    …Initiatives Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical ... York, as applicable. Certification by American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. 4. Knowledge, Skills and… more
    Catholic Health Services (03/05/25)
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  • Registered Nurse IV, Acute Care - Recovery

    Bassett Healthcare (Cooperstown, NY)
    …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
    Bassett Healthcare (05/20/25)
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  • Treatment Team Leader Developmental Disabilities…

    New York State Civil Service (Staten Island, NY)
    …policy, treatment, and therapeutic programs, and serves on committees such as placement, utilization review , medical records review , and related committees, ... Pathologist 2, Teacher 4 (and all parenthetics), Training Specialist 1 (Nursing), and Utilization Review Coordinator. Additional Comments * If you are currently… more
    New York State Civil Service (05/20/25)
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  • Registered Nurse, Acute Care - Emergency…

    Bassett Healthcare (Cooperstown, NY)
    …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
    Bassett Healthcare (05/20/25)
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  • Registered Nurse I, Acute Care - Medical Inpatient…

    Bassett Healthcare (Cobleskill, NY)
    …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
    Bassett Healthcare (05/20/25)
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  • Registered Nurse, Acute Care - Labor…

    Bassett Healthcare (Cooperstown, NY)
    …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
    Bassett Healthcare (05/20/25)
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  • Application Developer Analyst Level 1-5 (TCU…

    MTA (New York, NY)
    …5 $86,703 - $123,862 DEPT/DIV : Transportation IT Products SUPERVISOR : Product Manager , Construction Maintenance LOCATION : JCC Jamaica, New York HOURS OF WORK : ... * Test and debug routines and programs for efficient processing and maximum utilization of computer systems. * Participate in the investigation and resolution of… more
    MTA (05/10/25)
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  • Transplant Care Nurse RN - Stem Cell, Bone Marrow…

    Highmark Health (Albany, NY)
    …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
    Highmark Health (04/25/25)
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  • Courier Specialist

    Bassett Healthcare (Cooperstown, NY)
    …you'll do The Courier Specialist, in conjunction with the Courier Services Manager is responsible for the Bassett Healthcare Network Department of Courier Services. ... conform with network policies. Coordinate and support efforts with Courier Services Manager with operational tasks Foster an environment that focuses on decreasing… more
    Bassett Healthcare (05/20/25)
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