• Commercial Insurance Liaison

    UHS (Johnson City, NY)
    …clerical work + Previous experience in data processing + Certified home care and/or utilization review work experience Why You'll Love Working at UHS At United ... skills and a thorough understanding of insurance requirements. You'll review clinical documentation to confirm it meets agency and...Comprehensive Benefits for Life & Family - We offer medical , dental, and vision coverage starting the first of… more
    UHS (06/29/25)
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  • Revenue Integrity Analyst

    WMCHealth (Valhalla, NY)
    …experience in a hospital setting, preferably cardiology, radiology, surgery or utilization review , required. Previous revenue integrity experience, Excel and ... payors. + Develop, Implement and coordinate billing practices between hospital and physician groups to ensure uniform coding and documentation. + Recommend sound… more
    WMCHealth (06/27/25)
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  • Appeals Manager

    BronxCare Health System (Bronx, NY)
    …assist the department's leadership develop strategies for denial prevention, improved utilization management, documentation of medical necessity and identify ... and Medical Audit Contractors, and other licensing, accrediting, or review agencies. -Keeps current on concepts, techniques, and methods relative to areas… more
    BronxCare Health System (06/21/25)
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  • Credentialing Specialist-ONSITE

    WMCHealth (Hawthorne, NY)
    …of payer enrollment credentialing for the medical staff at Westchester Medical Center Advanced Physician Services. Primary responsibility of this position is ... for Quality Assurance (NCQA) in collaboration with WMCHealth Network Medical Staff Offices, accrediting organizations, and regulatory agencies. Does related… more
    WMCHealth (06/18/25)
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  • AI Research Associate

    Research Foundation CUNY (New York, NY)
    …will develop and adapt algorithms and models that can drive innovations in medical devices and diagnostics, healthcare access and utilization , and equitable ... CUNY School of Medicine (CUNY MED) is the only medical school in the City University of New York...Medicine also offers a Master of Science degree in Physician Assistant Studies. Our mission is to provide access… more
    Research Foundation CUNY (08/13/25)
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  • Senior Inpatient Coder (Remote)

    WMCHealth (Valhalla, NY)
    …trends and reports to the the coding leadership team. + Participates in mandated medical record review processes. + Using current ICD10 CM/PCS coding systems, ... code to all diagnoses, procedures, and operations as documented by the attending physician in the indicated patient's medical record. + Queries physicians for… more
    WMCHealth (06/26/25)
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  • Temporary-Managed Care Pharmacist

    CDPHP (Albany, NY)
    …care pharmacy principles including prior authorization reviews, formulary management, and utilization review preferred. + Experience with Microsoft Office, ... Care Pharmacist -Level I is primarily responsible for the operational review of pharmacy medical exception/prior authorization requests, the communication… more
    CDPHP (08/12/25)
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  • Staff Nurse (RN)

    UHS (Norwich, NY)
    …Services policy Shares responsibility for productivity and effective resource utilization including staffing, time management, supplies, and services + Complies ... Unit Council, participating in improvement initiatives, and contributing to peer review practices + Actively engages in professional development, continuing nursing… more
    UHS (06/27/25)
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  • Logistics RN Bed Management

    Bassett Healthcare (Cooperstown, NY)
    …admissions and transfers as well as overcoming delays and obstacles at Bassett Medical Center and throughout the network. Acts as a primary liaison between all ... Bassett Healthcare Network. This clinical position works in conjunction with the physician and/or staff and has the authority to prioritize bed allocation resources… more
    Bassett Healthcare (08/01/25)
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  • Social Worker - Emergency Department

    Garnet Health (Harris, NY)
    …for the detox patient on the medical floor assuring discharge planning, utilization review , and insurance approval. At Garnet Health, we are committed to ... Social Worker on our Emergency Department team at/in Garnet Health Medical Center-Callicoon. Responsibilities The Social Worker will be responsible for implementing… more
    Garnet Health (06/09/25)
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