• 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 (09/12/25)
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  • Medical Director

    Centene Corporation (New York, NY)
    …York + Board certified in Internal Medicine or Family Medicine + 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 (09/07/25)
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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 (09/11/25)
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  • RN/Case Manager-MSH-Case Management-PT-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 ... Requirements + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager… more
    Mount Sinai Health System (09/23/25)
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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 (08/27/25)
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  • Nurse Practitioner-Cardiothoracic- Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …and treatments plans are not required to be countersigned by a physician . **PRINCIPLES DUTIES AND RESPONSIBILITIES** **CLINICAL PRACTICE** + Assesses the health ... plan of care in the patient's medical record. + Consults with physician according to established standards, policies, procedures, and protocols. + Demonstrates the… more
    Mount Sinai Health System (08/03/25)
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  • Nurse Practitioner - Klingenstein 3 NICU - Mount…

    Mount Sinai Health System (New York, NY)
    …and treatments plans are not required to be countersigned by a physician . **PRINCIPLES DUTIES AND RESPONSIBILITIES** **CLINICAL PRACTICE** 1. Assesses the health ... plan of care in the patient's medical record. 5. Consults with physician according to established standards, policies, procedures, and protocols. 6.Demonstrates the… more
    Mount Sinai Health System (09/26/25)
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  • Medical Director, Commercial Line of Business

    Excellus BlueCross BlueShield (Rochester, NY)
    …Services area including, but not limited to, Medical and Pharmacy Utilization Management, quality management, member care management, and medical policy processes, ... I + Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review...of Medicine or Doctor of Osteopathic Medicine. + The Physician is not the subject of any pending professional… more
    Excellus BlueCross BlueShield (09/30/25)
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  • Medical Director (AZ)

    Molina Healthcare (Syracuse, NY)
    …and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource ... management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
    Molina Healthcare (09/26/25)
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  • Care Facilitator

    Rochester Regional Health (Rochester, NY)
    Job Title: Care Facilitator Department: Utilization ReviewLocation: Unity HospitalHours Per Week: Full Time - 40 HoursSchedule: Monday through Friday; Days; ... in the expected time frame and with most efficient utilization of resources. Carries out activities related to ...stay reviews, manages length of stay, and coordinates with Physician Advisors for complex cases. + Serves as a… more
    Rochester Regional Health (09/18/25)
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