• Staff Utilization Management Pharmacist

    Humana (Albany, NY)
    …Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior ... comprehensive reviews of medication care plans. This includes evaluating medical necessity, analyzing overall utilization, and identifying unusual usage patterns.… more
    Humana (08/27/25)
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  • Part Time Clinical Nutritionist

    Stony Brook University (Stony Brook, NY)
    …team members to ensure coordinated care. * Document patient interactions in the medical record in a timely and professional manner. * Provide caregiver education and ... clinical dietetics/nutrition preferably in neurology or critical care, or complex medical conditions. * Experience with enteral nutrition (tube feedings) required. *… more
    Stony Brook University (08/27/25)
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  • Site Supervisor- PTO / Benefits Available- $28.00…

    Sunstates Security (New York, NY)
    …work environments for its team across the country. We're committed to hiring , developing, and retaining a diverse and exceptionally qualified workforce. We reinvest ... of a successful, growing company. Job Skills / Requirements HIRING IMMEDIATELY Sunstates Security is currently hiring ...position is eligible for a full benefits package, including medical , dental, and vision insurance, generous PTO, 401k plan,… more
    Sunstates Security (08/26/25)
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  • Senior Social Art Director

    VF Corporation (New York, NY)
    …a competitive compensation package, and a strong benefits package that includes medical , dental, vision, and 401(k). Our commitment extends beyond this and into ... WE have a question for YOU.** **Are you in?** ** Hiring Range** **:** $96,800.00 USD - $121,000.00 USD annually...overview of each benefit program offered, including this year's medical plan rates on www.MyVFbenefits.com and by clicking **Looking… more
    VF Corporation (08/19/25)
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  • Revenue Specialist

    Stony Brook University (East Setauket, NY)
    …months of business experience, preferably in a healthcare setting such as revenue cycle, medical billing, or follow-up experience; or in lieu of degree, at least 2 ... preferably in a healthcare setting such as revenue cycle, medical billing, or follow-up experience. + Excellent written and...start date and/or revocation of the employment offer.** The hiring department will be responsible for any fee incurred… more
    Stony Brook University (08/19/25)
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  • Bilingual Telephonic UM Coordinator

    Humana (Albany, NY)
    …orders and arrange a safe facility discharge. + Work with UM Nurses, Pharmacy, Medical Directors and other Departments. + During downtime make calls to UM Nurses, ... with the CarePlus Platform. + Proficient and/or experience with medical terminology and/or ICD-10 codes. + Member service +...change based on business needs. As part of our hiring process, we will be using an exciting interviewing… more
    Humana (08/16/25)
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  • Encounter Data Management Professional

    Humana (Albany, NY)
    …to make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... researching medical claims + Proficient in Microsoft Office (Word, Excel,.../ HIPAA information **Interview Format:** As part of our hiring process for this opportunity, we will be using… more
    Humana (08/16/25)
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  • Patient Access Representative - Emergency Room…

    Stony Brook University (Stony Brook, NY)
    …hospital patient access, intake, registration experience. + Familiarity with medical insurance benefits, demonstrated experience with EMR computerized registration, ... financial, IT systems. + Knowledge of medical terminology. + Previous experience as a patient access...start date and/or revocation of the employment offer.** The hiring department will be responsible for any fee incurred… more
    Stony Brook University (08/16/25)
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  • Senior Encounter Data Management Professional

    Humana (Albany, NY)
    …skills to make an impact** **Required Qualifications** **5+ years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep ... team leadership experience** **Demonstrated experience in managing projects effectively** ** Medical claims experience** **Additional Information** **_This position may be… more
    Humana (08/15/25)
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  • Manager Utilization Management

    Elevance Health (Latham, NY)
    …substance abuse services for one or more member product populations of varying medical complexity ensuring the delivery of essential services that address the total ... Reviews benefit systems and cost benefit analysis. + Evaluates medical , mental health and substance abuse service for cost...Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of… more
    Elevance Health (08/13/25)
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