• Clinical Reviewer, Nurse Practitioner/…

    Evolent (Albany, NY)
    …Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/ Physician Assistant (ARNP/NP/PA) Vascular Surgey is responsible for support and assistance ... for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices of the office of the Chief Medical… more
    Evolent (01/15/26)
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  • Physician Support Rep III

    University of Rochester (Rochester, NY)
    …staff, nursing, echocardiology, and /or surgeons.) As well as room utilization , ancillary tests, laboratory studies and required testing equipment. Facilitate ... pertinent medical information at the time of call from patient, referring physician and/or other health care professionals. Evaluate urgency of response and… more
    University of Rochester (10/30/25)
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  • Physician Peer Reviewer NY Licensed…

    Healthfirst (NY)
    …Peer Reviewer will: + Maintain productivity standards. + Collaborate with Utilization Management and Care Management and medical departments as needed, reviews ... in Internal Medicine or Family Practice + Previous, relevant experience in utilization management and clinical practice + Knowledge of Medicare, Medicaid, and MLTC… more
    Healthfirst (11/13/25)
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  • Case Manager, RN- Case Management

    Northwell Health (Staten Island, NY)
    …166750 Job Description Serves as liaison between the patient and facility/ physician . Ensures a continuum of quality patient care throughout hospitalization and ... delays and resolves issues with appropriate departments. + Identifies appropriate utilization of Social Work Services and makes referrals when appropriate. +… more
    Northwell Health (01/17/26)
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  • Financial Analyst- ONSITE

    WMCHealth (Hawthorne, NY)
    …AR, payor mix, billing throughput and other performance statistics. + Physician and Mid-level provider productivity, utilization , patient referrals, ... and forecast financial performance. + Coordinate with practice operations and physician leaders to develop and oversee transition plan for capital assets,… more
    WMCHealth (12/12/25)
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  • Medical Director

    Centene Corporation (New York, NY)
    …+ Board certified in Internal Medicine or Family Medicine preferred + Utilization Management experience and knowledge of quality accreditation standards. + Actively ... for the business unit. + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs… more
    Centene Corporation (01/06/26)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …appropriate Level of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional ... provided by the Case Manager include, but are not limited to, utilization review, case management, care transition, collaboration with physicians and social workers… more
    Ellis Medicine (12/11/25)
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  • Customer Success Manager - Engagement Manager

    Wolters Kluwer (Colonie, NY)
    …Engagement Manager plays a high-impact role in managing strategy and product utilization across the Wolters Kluwer Health's Clinical Decision Support & Provider ... are established and strengthened, drive product adoption and ensure utilization goals are achieved to maximize value realization, implementation projects… more
    Wolters Kluwer (12/10/25)
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  • RN/Case Manager-MSH-Case Management-FT-Days

    Mount Sinai Health System (New York, NY)
    …on reducing the length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice and may require ... Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a… more
    Mount Sinai Health System (01/13/26)
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  • RN Acute Case Manager - System Care Management…

    Guthrie (Binghamton, NY)
    …of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and ... for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with other internal… more
    Guthrie (11/26/25)
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