• Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    …and tactics to successfully execute, support, implement, and monitor the DRG and Utilization Management Clinical Denial teams Work Plan and, assists in the ... facilitating strong working relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments and… more
    Kaleida Health (06/19/25)
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  • Medical Director, Children's Services (SafetyNet…

    Excellus BlueCross BlueShield (Buffalo, NY)
    management rounds. + Provision of clinical oversight and leadership to Utilization Management /Case Management (UM/CM) staff working with the children's ... Develops and implements the BH sections of the Quality Management / Utilization Management (QM/UM) Plan, including...+ Must hold a NYS medical license as a physician board certified in child and adolescent psychiatry without… more
    Excellus BlueCross BlueShield (08/09/25)
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  • Clinical Program Manager - Clinical Command Center…

    Mount Sinai Health System (New York, NY)
    …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day ... patient-centered care. **Qualifications** Must be a Licensed Registered Nurse, Physician Assistant or Nurse Practitioner Registered Nurse Bachelor's Degree in… more
    Mount Sinai Health System (08/09/25)
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  • Chief Hospitalist & Director Inpatient Quality

    Veterans Affairs, Veterans Health Administration (Bronx, NY)
    …manner. Provide evidence-based clinical care for medical inpatients. General Management of Hospitalist Team: Review relevant Internal Medicine Service performance ... HCAP Care transitions Hospital Rating Hospital wide readmissions Mortality Utilization of Clinical Pathways Development of performance improvement priorities and… more
    Veterans Affairs, Veterans Health Administration (06/14/25)
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  • Care Coordinator II

    Spectrum Health and Human Services (Buffalo, NY)
    …The Care Coordinator will apply the essential activities of case management which include assessment, planning, coordination, monitoring and evaluation with the ... core components (Comprehensive Case Management , Care Coordination & Health Promotion, Comprehensive Transitional Care, Patient and Family Support and Referral to… more
    Spectrum Health and Human Services (07/16/25)
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  • Dialysis Charge Registered Nurse - RN

    Fresenius Medical Center (Schenectady, NY)
    …support to patients and staff. Assists with staffing, staff training, equipment, physician and patient relations, cost containment, supply management , medical ... SCOPE:** Works with the Facility Manager, facility staff and physician to coordinate the facility operations and patient procedures...as defined by the quality goals, by working with management to ensure that policies and procedures are followed.… more
    Fresenius Medical Center (06/28/25)
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  • Care Coordinator RN SJC Mercy Comprehensive Care

    Catholic Health (Buffalo, NY)
    …experience as a registered nurse required + One year previous case, disease, or utilization management experience preferred + One year previous experience in a ... improve compliance with evidence based clinical guidelines, encourage patient self- management , increase coordination of care, increase the utilization...physician office or ambulatory care setting preferred KNOWLEDGE +… more
    Catholic Health (07/23/25)
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  • Care Manager - Per Diem

    Stony Brook University (Stony Brook, NY)
    …to our high standard of excellence. **Duties of a Care Manager in the Care Management Department may include the following but are not limited to:** + Completes ... Utilization review screen for inpatient and observation cases. Activity...assigned. Identifies, follows and documents Avoidable delays in Care Management Program. Reviews and documents on patients who were… more
    Stony Brook University (07/15/25)
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  • Dialysis Charge Registered Nurse - RN

    Fresenius Medical Center (Rochester, NY)
    …support to patients and staff. Assist with staffing, staff training, equipment, physician and patient relations, cost containment, supply management , medical ... **PURPOSE AND SCOPE:** Works with the Facility Manager, facility staff and physician to coordinate the facility operations and patient procedures to ensure provision… more
    Fresenius Medical Center (07/05/25)
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  • Territory Manager, Pcio - NYC/Long Island

    Abbott (Hauppauge, NY)
    …This includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management ... on clinical differentiation in the procedure, value proposition, product launch, physician onboarding, early case coverage and training. + Secondary responsibility… more
    Abbott (08/11/25)
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