- Independent Health (Buffalo, NY)
- …and a culture that fosters growth, innovation and collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review to determine the medical ... experience as an RN in a varied clinical setting required. + Previous utilization review experience preferred. + Previous experience in a managed care setting… more
- WMCHealth (Valhalla, NY)
- Asst Utilization Coordinator Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing/Nursing Management Department: Clinical Care Management ... Applicant link Job Details: Internal Posting: 07/1/25 to 07/14/25 Assistant Utilization Coordinator Summary: Under general supervision, an incumbent of this class… more
- New York State Civil Service (New York, NY)
- …Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review, P26749 Occupational Category Health Care, Human/Social Services Salary ... NY Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily Utilization… more
- Catholic Health Services (Melville, NY)
- …Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... payors for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required.… more
- Molina Healthcare (Yonkers, NY)
- …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and cost control issues… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. * ... Completes Utilization Management and Quality Screening for assigned patients.* Applies...and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and… more
- Monroe County, NY (Rochester, NY)
- Full Jobs List Full Exams List Registered Nurse (RN) - Utilization Review Unit, Per Diem Location: Rochester, NY Title: Registered Nurse (RN) - Utilization ... Agency/Dept.: Monroe Community Hospital Description of Duties This position is in the Utilization Review Unit and functions as an assessment nurse. This is a… more
- Guthrie (Binghamton, NY)
- …care services regarding admissions, case management, discharge planning and utilization review. Responsibilites: Reviews admissions and service requests within ... needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and coordinates compliance to federally… more
- Samaritan Daytop Village (Rhinebeck, NY)
- …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as needed ... with assuring compliance with external and internal utilization review/quality and appropriateness requirements. What qualifications do you need: + Bachelor degree… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more