• Residential SUD Counselor - 127 West 25th Street

    Bowery Residents Committee (Manhattan, NY)
    …plans, and crisis intervention. Gather and review documentation as requested for utilization management reviews of clients on caseload including completion of ... MSW or CASAC-T License required. LMHC or LMSW preferred. Excellent time management skills. Bachelors strongly preferred. Knowledge of OASAS rules and regulations and… more
    Bowery Residents Committee (09/30/25)
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  • Care Review Clinician, Inpatient Review (RN)

    Molina Healthcare (Albany, NY)
    …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... software program(s) proficiency. Preferred Qualifications * Certified Professional in Healthcare Management (CPHM). * Recent hospital experience in an intensive care… more
    Molina Healthcare (09/25/25)
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  • Sr Analyst, Performance Suite Analytics

    Evolent (Albany, NY)
    …various sites of care/service is preferred + Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the ... will partner closely with executives across analytics, finance, product and account management . **What You Will Be Doing:** + Support Business Development & Product… more
    Evolent (09/22/25)
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  • Psychologist Reviewer

    Centene Corporation (New York, NY)
    …Interact with network practitioners to provide education on best practice models and utilization management processes + Interact with the Medical Director, or ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (09/05/25)
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  • Health Insurance & Authorization Specialist I

    Highland Hospital (Rochester, NY)
    …benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests **Salary Range:** ... for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates… more
    Highland Hospital (09/02/25)
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  • Home Care Relations Liaison

    Centers Plan for Healthy Living (Staten Island, NY)
    …with CDPAS documentation and authorizations. PRIMARY RESPONSIBILITIES: + Point person for Utilization Management , Case Management and G&A regarding ... resolution to members request for a change in provider + Communicate with current provider regarding stabilizing services + Communicate with providers regarding staffing new cases + Assist delegating CDPAS documentation to appropriate departments + Correspond… more
    Centers Plan for Healthy Living (07/15/25)
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  • Clinical Support Specialist

    CDPHP (Latham, NY)
    …two (2) years experience in a health insurance related discipline required. + Utilization management experience is preferred. + Knowledge of managed care, health ... CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services,… more
    CDPHP (07/06/25)
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  • Project Manager, Utilization - MWBE

    New York State Civil Service (New York, NY)
    NY HELP No Agency Empire State Development, NYS Title Project Manager, Utilization - MWBE Occupational Category Other Professional Careers Salary Grade NS Bargaining ... direct supervision of the Director of Contract Participation, the Project Manager, Utilization , will lead the planning, execution, and monitoring of key initiatives… more
    New York State Civil Service (09/04/25)
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  • Senior Manager, Lab Planning & Design

    Regeneron Pharmaceuticals (Tarrytown, NY)
    …Excel and PowerPoint; AutoCAD/Building Information Modeling/Revit, CAFM/IWMS or other space management / utilization software; knowledge of TRIRIGA a plus + Must ... customers (users), collaborators (leaders), and partners (Real Estate & Facilities Management , Research Operations) to understand user requirements and develop lab… more
    Regeneron Pharmaceuticals (07/23/25)
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  • Admissions Coordinator

    Tarrytown Rehabilitation & Nursing Center (Clinton County, NY)
    …concurrent review package. + . Submitting concurrent review package and follow up with Utilization Management team at the Managed Care Plan for status. + . ... Submit daily referral report. + . Submit on a weekly basis an outreach log of who/which external community partners/ hospitals were contacted for possible admissions. + . Admissions Coordinator must attend Outreach events on behalf of the Skilled Nursing Home… more
    Tarrytown Rehabilitation & Nursing Center (09/20/25)
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