• Field Medical Director, MSK (Spine) Surgery

    Evolent (Albany, NY)
    …specialty match reviewer for Spine Surgery cases. 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 (07/02/25)
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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 (07/02/25)
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  • RN/Case Manager-Inpatient-Mount Sinai West-FT-Days…

    Mount Sinai Health System (New York, NY)
    …NYSNA-SLW NYSNA at Mount Sinai St. Luke's and Mount Sinai West, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** 1. Principle Duties and ... are not limited to: 1. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using… more
    Mount Sinai Health System (07/08/25)
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  • Case Manager - UM II -100%

    Healthfirst (NY)
    The Case Manager, Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... and case management as assigned. The Case Manager, Utilization Management is also responsible for efficient utilization of health services and optimal… more
    Healthfirst (08/08/25)
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  • Pharmacist - Clinical Advisor

    CVS Health (Albany, NY)
    …o Consulting with and recommending standard and custom formulary options and utilization management edits. o Collaborating with internal partners to develop ... value and drives lowest net cost. o Consulting with and recommending utilization management programs or other clinical programs to a client. o Consulting with… more
    CVS Health (07/29/25)
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  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... 3 years acute hospital care experience not required. PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience preferred. + Bachelor's… more
    Rochester Regional Health (07/25/25)
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  • Senior Associate, Treasury Management

    Capital One (New York, NY)
    …onboard their products/services and support them in ramping up to full utilization . Treasury Management Associates regularly identify opportunities to improve ... Senior Associate, Treasury Management Associate Aligned to one or more Commercial...one or more Commercial Banking business segments, the Treasury Management Associate (TMA) provides primary sales support to aid… more
    Capital One (08/08/25)
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  • Field Medical Director , Radiology (Urology)

    Evolent (Albany, NY)
    …Doing:** Job Description As a FMD, Radiology 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 (08/02/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …Services discharge planning guidelines and departmental/organizational policies and processes + Utilization Management : + Ensures order in chart/EMR coincides ... services provided by the Case Manager include, but are not limited to, utilization review, case management , care transition, collaboration with physicians and… more
    Ellis Medicine (07/25/25)
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  • Provider Engagement Account Manager

    Centene Corporation (Queens, NY)
    …or medical group experience, provider relations, quality improvement, claims, contracting utilization management , or clinical operations. Project management ... align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in… more
    Centene Corporation (06/07/25)
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