• RN Lead, Healthcare Services

    Molina Healthcare (Buffalo, NY)
    … management , care transitions, long-term services and supports (LTSS), behavioral health , and other clinical programs, and collaborates with ... at least 2 years of managed care experienced in utilization management * Registered Nurse (RN) ONLY...practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional… more
    Molina Healthcare (09/26/25)
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  • Pharmacy Coordinator

    Highmark Health (Albany, NY)
    …Wholecare's pharmacy programs with a focus on medication adherence and optimizing member health outcomes. This role involves a high volume of daily contacts with ... address medication-related issues, promote adherence, and ensure appropriate medication utilization . **ESSENTIAL RESPONSIBILITIES** + Communicate effectively with physicians and… more
    Highmark Health (09/19/25)
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  • Pharmacy Benefit Consultant

    Highmark Health (Albany, NY)
    …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year of ... + In-depth knowledge of the pharmacy industry, including benefit design, formulary management , and pharmacy best practices. + Proven ability to interpret and analyze… more
    Highmark Health (08/26/25)
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  • AVP of OR/Peri-Op Services

    Albany Medical Center (Albany, NY)
    …short- and long-term goals and objectives. As a member of the nursing executive management team, the AVP participates in the efficient and effective management ... development of its strategic plan. Education: + A Master's Degree in health , business, education or related field. Licensure, Certification & Registration: + Must… more
    Albany Medical Center (09/27/25)
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  • Social Worker II

    Ellis Medicine (Schenectady, NY)
    …implement and evaluate individual healthcare needs. Integrate Discharge Planning, Utilization Review and Performance Improvement activities at the patient, hospital ... levels. Efficiently and effectively anticipates, identifies and resolves issues through utilization review and discharge planning processes. Collaborates with the ED… more
    Ellis Medicine (09/23/25)
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  • Full Time Licensed Social Worker

    Outreach Development Corporation (Brentwood, NY)
    …that helps people address the issues stemming from substance use and behavioral health disorders by providing the highest quality, life-changing treatment, ... of unlimited potential by developing and delivering the highest quality evidence-based behavioral health services and training. For more information, please… more
    Outreach Development Corporation (10/02/25)
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  • Social Work Care Manager

    Elderwood (Buffalo, NY)
    …may require interventions. + Participate in Interdisciplinary Team meetings, Disease Management , Utilization Management , and Quality Improvement activities ... working with a frail or elderly population and/or members with chronic illness or behavioral health issues. + Previous Managed Care experience, within a MLTC or… more
    Elderwood (08/16/25)
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  • Psychiatrist - Inpatient

    St. Mary's Healthcare (Amsterdam, NY)
    …seeking a dedicated Inpatient Psychiatrist to join our compassionate and experienced Behavioral Health team in Amsterdam, NY. This full-time, hospital-employed ... patient-centered care. St. Mary's is committed to improving access to integrated behavioral health services across Fulton/Montgomery County and the surrounding… more
    St. Mary's Healthcare (08/08/25)
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  • CARE Case Manager, Undergraduate Students

    University of Rochester (Rochester, NY)
    …NABITA rubric and implementing appropriate interventions. + Receive referrals from the Behavioral Intervention Team (BIT) to provide case management services and ... evening and weekend hours. **ESSENTIAL FUNCTIONS** CARE Student Case Management : + Maintain a caseload of CARE referrals for...as suicidal ideation and/or attempt, substance use, serious mental health , and other behavioral issues. + Document… more
    University of Rochester (09/11/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Rochester, NY)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.… more
    Molina Healthcare (09/05/25)
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