• Discharge Planner

    Ellis Medicine (Schenectady, NY)
    …function is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to facilitate patient discharge plans, support coordination of ... care activities, and assist in utilization management activities under the direction of a registered nurse and/or social worker. Responsibilities include… more
    Ellis Medicine (08/28/25)
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  • Case Manager RN

    Bassett Healthcare (Oneonta, NY)
    …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... barriers to efficient delivery of care in appropriate setting. + Completes utilization management and quality screening for assigned patients. + Applies… more
    Bassett Healthcare (09/18/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Albany, NY)
    …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to ... meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use… more
    Evolent (07/30/25)
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  • Sr Director Quality Management & Regulatory…

    Mohawk Valley Health System (Utica, NY)
    …+ 8 years of clinical experience. Previous or current experience working in Quality Management / Utilization Management field. + 5 years of management ... Sr Director Quality Management & Regulatory Affairs - Full Time -...QUALITY IMPROVEMENT Job Summary The Senior Director of Quality Management Systems and Regulatory Affairs is responsible for establishing… more
    Mohawk Valley Health System (07/09/25)
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  • Transitional Care RN - Case Management…

    Mohawk Valley Health System (Utica, NY)
    …+ 3 years of clinical experience. + Strong computer skills. PREFERRED: + Case Management , Utilization Management and Quality Management experience ... Transitional Care RN - Case Management - Full Time - Days Department: CASE MANAGEMENT Job Summary The RN - Transitional Care Coordinator is responsible for… more
    Mohawk Valley Health System (07/09/25)
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  • Medical Director, Behavioral Health (TX/WA)

    Molina Healthcare (Syracuse, NY)
    …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental ... care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management programs for… more
    Molina Healthcare (09/13/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …range of medical/clinical knowledge. + Expertise in, or willing to learn utilization management , state/federal regulations, private payer contracts. + Dedication ... medical license. PREFERRED: + Certification preferred or eligibility for certification in utilization management via certifying boards within 1-2 years of… more
    Mohawk Valley Health System (07/09/25)
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  • Field Medical Director, Cardiology

    Evolent (Albany, NY)
    …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (10/01/25)
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  • Field Medical Director - Vascular Surgery

    Evolent (Albany, NY)
    …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (08/28/25)
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  • Care Facilitator

    Rochester Regional Health (Rochester, NY)
    …efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... York State as a Registered Nurse PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience + Bachelor's Degree EDUCATION: LICENSES /… more
    Rochester Regional Health (09/18/25)
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