• Quality Technician

    GE Vernova (Schenectady, NY)
    …manufacturing standards/work instructions for new technology, quality data collection, review , package preparation and submission process for quality acceptance of ... Responsibilities** + Coordinate all aspects of the quality data review and submission for approval process for product shipment...drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program,… more
    GE Vernova (08/28/25)
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  • Director, Physician Leadership - Medical Directors…

    Humana (Albany, NY)
    …a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million ... Responsibilities** **:** + Lead an operational team of Medical Directors to review authorizations and ensure clinical decision-making skills that align to internal… more
    Humana (08/21/25)
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  • Clinical Denials & Appeals Specialist (Remote)

    Northwell Health (Melville, NY)
    …and billing status and ensures compliance with the Utilization Review standard and regulations. Performs concurrent and retrospective utilization management ... of illness and intensity of services provided. Performs PRI's (Patient Review Instrument), as needed. Performs related duties as required. All responsibilities… more
    Northwell Health (08/20/25)
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  • Case Manager, RN- Rehab Comprehensive IRF

    Northwell Health (Staten Island, NY)
    …* Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of stay. + ... Sheet and the Patient Transfer Sheet. + Ensures Patient Review Instrument (PRI) is completed and reflects clinical profile...+ Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification,… more
    Northwell Health (08/08/25)
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  • Faculty, Full Time Tenure Track, Psychiatric…

    Monroe Community College (Rochester, NY)
    …classes; develop new educational materials; assist with curriculum development, review , and assessment; perform professional duties; and participate in departmental ... with student retention and completion initiatives + Assists with development, review , and revision of department curriculum, including assessment of student learning… more
    Monroe Community College (08/08/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective authorization and ... with physicians and other Arnot Health departments in matters of auth/denial review decisions. 8. Maintains a working relationship with Physician Advisor regarding… more
    Arnot Health (08/08/25)
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  • Asst Utilization Coordinator

    WMCHealth (Valhalla, NY)
    …investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester Medical Center. Depending upon ... assignment, incumbents may implement the review /screening aspects of the Quality Improvement Plan; monitor the...York State Department of Education, as a registered professional nurse . Training and Experience: three years of experience where… more
    WMCHealth (08/02/25)
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  • Faculty, Full Time Tenure Track, Nursing

    Monroe Community College (Rochester, NY)
    …faculty teach classes, develop new educational materials, assist with curriculum review and assessment, perform professional duties, and participate in departmental ... completion initiatives, including early alert + Assists with the development, review , and revision of department curriculum, including assessment of student learning… more
    Monroe Community College (08/01/25)
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  • Clinical Data Abstractor

    WMCHealth (Suffern, NY)
    …are required for regulatory and NYS registries. The Clinical Data Abstractor will review the quality metrics and support the multidisciplinary clinical teams to ... review processes and make improvements as identified and needed....the New York State Education Department, as a Registered Nurse required. Other: Excellent intrapersonal and time management skills,… more
    WMCHealth (07/28/25)
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  • RN Unit Manager - Taylor Health

    Arnot Health (Bath, NY)
    …Care staff, attends weekly care conference meetings, and weekly Medicare A review with care team and therapies. + Demonstrates effective time management, flexibility ... of resident care. e. Assists the DON with implementing appropriate review systems for competency-based appraisals of staff. f. Participates in Nursing/Medical… more
    Arnot Health (07/28/25)
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