• RN OB Case Manager

    Highland Hospital (Rochester, NY)
    …the OB RN Care Manager's central role integrates and coordinates access and utilization management , proactive patient management , care facilitation and ... **17006BR** **Title:** RN OB Case Manager **Department/Cost Center:** 628 - Ayrault Womans...nursing experience preferred. Progressive clinical experience; community health, care management , and/or disease management is preferred. Experience… more
    Highland Hospital (07/23/25)
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  • Medical Director, Commercial Line of Business

    Excellus BlueCross BlueShield (Rochester, NY)
    …Essential Accountabilities: Level I + Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review ... case review determinations. + Provides input into the utilization management program policies and procedures. +...periods of time for business continuity. + Ability to travel across the Health Plan service region for meetings… more
    Excellus BlueCross BlueShield (07/01/25)
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  • Coordinator Integrated Disability…

    Catholic Health (Buffalo, NY)
    …licensure preferred EXPERIENCE + Minimum of three (3) to five (5) years of claims management or disability case management work experience required + Claims/ ... in a health related, human services or legal field preferred + Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), and/or claim… more
    Catholic Health (06/12/25)
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  • Physician Advisor

    WMCHealth (Valhalla, NY)
    …administrative support and leadership to the utilization and resource management areas of Integrated Case Management including mentoring/coaching ... a third party leveling and/or appeals agency preferred. Previous utilization management , case management...Osteopathic Specialties (ABOS) preferred. Other: Has the ability to travel among the WMC HEALTH NETWORK hospitals on a… more
    WMCHealth (05/22/25)
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  • Deputy Director Enterprise Asset Management…

    MTA (New York, NY)
    …mindset and utilization of data analytics to establish more efficient management and maintenance practices of our physical assets. The selected individual must ... Deputy Director Enterprise Asset Management Value Realization Job ID: 6664 Business Unit:...and problem-solving skills, together with demonstrated proficiency in business case development and implementation planning. + General knowledge and… more
    MTA (06/10/25)
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  • Director, Physician Leadership - Medical Directors…

    Humana (Albany, NY)
    …Director, Physician leadership will lead Medical Directors performing utilization management for Medicare inpatient and behavioral medicine case types. This ... role, you will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus… more
    Humana (07/26/25)
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  • Medical Director - South Carolina SE Region

    Humana (Albany, NY)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/22/25)
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  • Medical Director - Gulf South

    Humana (Albany, NY)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/08/25)
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  • Medical Director - Mid West Region

    Humana (Albany, NY)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (05/14/25)
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  • Medical Director - NorthEast Region

    Humana (Albany, NY)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/25/25)
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