• Manager, Medical Economics (New York Health Plan)

    Molina Healthcare (Buffalo, NY)
    …and Finance team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and dashboard ... information from data sources. + Knowledge of healthcare operations ( utilization management, disease management, HEDIS quality measures, claims processing, etc.)… more
    Molina Healthcare (11/21/25)
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  • Healthcare Services Auditor (RN) (New York)

    Molina Healthcare (Bronx, NY)
    …cost-effective member care. Essential Job Duties * Performs audits in utilization management, care management, member assessment, behavioral health, and/or other ... years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant… more
    Molina Healthcare (11/21/25)
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  • Case Management Supervisor - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision ... Provides direct oversight of the case manager's daily operations of utilization review practice, process and procedures ensuring accurate member care needs… more
    Mohawk Valley Health System (11/21/25)
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  • UM Coordinator 2 - Weekend Work

    Humana (Albany, NY)
    …first** The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities ... utilizing electronic medical record and documentation programs + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
    Humana (11/20/25)
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  • Project Manager

    SUNY Geneseo (Geneseo, NY)
    …in the SUNY MWBE Administration AXI system. -Receive monthly and quarterly MWBE utilization reports on all active projects from consultants and contractors. - Verify ... consultants and contractors utilization reports are submitted in the SUNY MWBE online...- provide consultants and contractors written notice when approved utilization goals are not being obtained. - Conduct quarterly… more
    SUNY Geneseo (11/19/25)
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  • Senior Intake Coordinator

    Highmark Health (Buffalo, NY)
    …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses the verbal ... benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc.… more
    Highmark Health (11/18/25)
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  • Intake Coordinator

    Highmark Health (Buffalo, NY)
    …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses the ... the member, and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review. Ensures all accurate… more
    Highmark Health (11/18/25)
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  • Commercial Review Specialist I

    SUNY Upstate Medical University (Syracuse, NY)
    …reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients are at the appropriate ... PC, Windows, Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, experience… more
    SUNY Upstate Medical University (11/18/25)
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  • Analyst Capacity Management (On-site)

    Saratoga Hospital (Saratoga Springs, NY)
    …scheduling tools and data driven capacity planning, the Analyst helps ensure optimal utilization of resources, and improved access to care. What You'll Do EPIC ... Analyzes key access metrics including, but not limited to: schedule utilization , provider utilization , no show rate, late cancelation rate, third next available… more
    Saratoga Hospital (11/18/25)
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  • Civil Engineering Department Manager

    Colliers Engineering & Design (New York, NY)
    …of work and the sharing of resources within the discipline, maximizing staff utilization . Reviews staff utilization regularly and promptly addresses staff not ... meeting utilization goals. + Actively involved with business development and the cross-selling of all company services. + Prepares for the future state of the discipline through succession planning in a timely manner. + Holds people managers within the… more
    Colliers Engineering & Design (11/18/25)
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