• Pharmacy Prior Authorization Technician

    Excellus BlueCross BlueShield (Rochester, NY)
    …drug policies and procedures. This position accurately prepares and interprets cases for UM ( utilization management ) reviews and determination. In addition, ... to ensure delivery of consistent and quality health care services examples include Utilization Management , Quality Management and Case Management .… more
    Excellus BlueCross BlueShield (11/19/25)
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  • Clinical Pharmacy Specialist, Pharmacy Benefits…

    Northwell Health (New Hyde Park, NY)
    …responsible for the development, implementation, and maintenance of drug formularies, clinical utilization management ( UM ) criteria, and evidence-based drug ... findings. + Performs all duties of a licensed registered Pharmacist as required by the leadership and as identified...in formulary management , P&T committee support, and/or utilization management (PA, ST, QL) criteria development… more
    Northwell Health (11/13/25)
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  • Case Manager, RN or Licensed Behavioral Health…

    Excellus BlueCross BlueShield (Rochester, NY)
    …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
    Excellus BlueCross BlueShield (11/20/25)
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