• Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …queries from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, ... a home health service, hospice and a network of physician practices across the island. At Catholic Health, our...was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews… more
    Catholic Health Services (07/24/25)
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  • RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    …care services regarding admissions, case management, discharge planning and utilization review. Responsibilites: Reviews admissions and service requests within ... assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimburesement policy criteria. Provides case management and/or… more
    Guthrie (07/05/25)
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  • Utilization Review Nurse

    CDPHP (Albany, NY)
    …for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical...This includes approval determinations and appropriate exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse… more
    CDPHP (08/03/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …hospitals objectives, and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides the team to ... PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The...correct level of care and reimbursement. Apply knowledge of utilization review, discharge planning, patient status changes, length of… more
    Mohawk Valley Health System (07/09/25)
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  • Director Physician Advisor

    Catholic Health Services (Melville, NY)
    …department, and presents to Physician Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. ... hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the… more
    Catholic Health Services (06/27/25)
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  • Nurse Practitioner/ Physician Assistant 2nd…

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: The Nurse Practitioner or Physician Assistant will be responsible for providing obstetrical and gynecological patient care within the scope and ... outpatient patient population within a supervising practice agreement established with a specific physician on the staff of the Department of OB GYN, University OB… more
    SUNY Upstate Medical University (07/16/25)
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  • Physician / Medical Director

    STG International (West Seneca, NY)
    …the Primary Care Physician is to provide covered professional outpatient primary medical services to enrolled patients of the Veterans Affairs Medical Center ... full and unrestricted medical license in the state in which the physician practices. (State specific license in which the CBOC is located required). +… more
    STG International (06/07/25)
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  • Medical Director Physician

    Mount Sinai Health System (New York, NY)
    **Job Description** **Mount Sinai Health System is seeking a Medical Director of Physician Engagement and CDQI!** **Background:** Mount Sinai is one of the ... improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI,...for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of… more
    Mount Sinai Health System (06/03/25)
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  • Physician -Vascular Interventional…

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    Summary This position is located at the Albany Stratton VA Medical Center, Albany, New York in the Department of Diagnostic Imaging. The Vascular Interventional ... duties and responsibilities are performed throughout the Albany Stratton VA Medical Center, often in a close interdisciplinary arrangement and consultation with… more
    Veterans Affairs, Veterans Health Administration (07/31/25)
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  • Physician Assistant-Qhc-13601-002

    Mount Sinai Health System (Jamaica, NY)
    **Job Description** Under the general supervision of a licensed and Board-Certified Physician , evaluates and treats adult patients having medical , psychiatric, ... entries in patients' charts. 5. Completes and documents participation in continuing medical education required of Physician Assistants in order to meet… more
    Mount Sinai Health System (07/16/25)
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