• Case Review Specialist

    City of New York (New York, NY)
    …which ultimately hinders the case from obtaining a court order. Improving the review of case data facilitates productive data matches, which increases OCSS's ability ... (OCSS) is recruiting four (4) Clerical Associate III's, functioning as Case Review Specialists, Under supervision of the Unit Supervisor of Data Integrity, with… more
    City of New York (10/25/25)
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  • Admin. Engineer M-II - Chief Of Review

    City of New York (New York, NY)
    …The Bureau of Water & Sewer Operations seeks to hire a Chief of Review and Permitting within the Division of Engineering, Connections and Permitting. The Review ... Water and Sewer Permitting unit and the Sewer Connection Review unit. The Deputy Chief of the Water and...as administrative staff. The group is responsible for the review and permitting of water and sewer service connections,… more
    City of New York (11/12/25)
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  • Personnel Review Analyst

    City of New York (New York, NY)
    …Impact The Budget Expense Unit seeks a dynamic, resourceful, and organized, Personnel Review Analyst to assist with managing the agencies personnel review ... Responsibilities Under supervision of the Deputy Director of Personnel Review within the Division of Budget you will be...of Budget you will be responsible to manage personnel review for the Office of Enforcement and Neighborhood Services… more
    City of New York (11/05/25)
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  • PA Office Support Representative

    Highmark Health (Buffalo, NY)
    …:** Highmark Inc. **Job Description :** I. GENERAL OVERVIEW: * Receive, review and make determinations regarding physician reviewer assignments for medical ... II. ESSENTIAL RESPONSIBILITIES: 1. Responsible for the timely receipt, review and assignment of all incoming physician reviewer... review and assignment of all incoming physician reviewer referrals and appeals to ensure that NCQA, URAC,… more
    Highmark Health (11/18/25)
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  • Medicaid Quality Control Case Review

    City of New York (New York, NY)
    …Principal Administrative Associate, who will function as a Medicaid Quality Control Case Review Supervisor who will: - Review the audit findings determined by ... the Quality Control Case Reviewers to ensure they are relevant and appropriate. Review the programs' responses to error findings and determine whether MAQC agrees or… more
    City of New York (11/05/25)
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  • Review Physician

    Fedcap (New York, NY)
    Position Summary: The Review Physician works in close collaboration with Clinical Services Department staff and is responsible for review of all applicable ... of assessments to determine and/or confirm FCO + Create review reports based on findings + Perform a comprehensive... reports based on findings + Perform a comprehensive review of systems + Conduct assessment review more
    Fedcap (09/05/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Albany, NY)
    JOB DESCRIPTION **Job Summary** The Care Review Clinician RN provides support for clinical member services review assessment processes. Responsible for verifying ... Candidates with MCO experience are highly preferred. The Care Review Clinician must be able to work independently in...Candidates with MCO experience are highly preferred. The Care Review Clinician must be able to work independently in… more
    Molina Healthcare (11/26/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (New York, NY)
    …with our Children member's - ages 0-18.** **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. Monitors ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of… more
    Centene Corporation (11/08/25)
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  • Accounts Review Specialist

    Elderwood (Buffalo, NY)
    …Pharmacy Billing Department in Williamsville, NY is seeking an experienced, detail-oriented Accounts Review Specialist to join our team and make a difference in the ... employee reward program: redeem for prizes! Responsibilities Accounts Receivable Review Specialist Responsibilities: + Assisting to facilitate collections of past… more
    Elderwood (10/28/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and contacts ... Demonstrates proper use of MCG and documentation requirements through case review and inter-rater reliability studies.* Facilitates removal of delays and documents… more
    Albany Medical Center (11/25/25)
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