• Health Insur & Auth Rep III

    University of Rochester (Rochester, NY)
    …Medicare and other payer regulations for the coordination of benefits. + Notifies Utilization Management of clinical requests by third party payers. + Maintains ... considerations._ **Responsibilities:** GENERAL PURPOSE Manages and provides financial account management for all urgent, emergent, and pre-admission visits with a… more
    University of Rochester (01/02/26)
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  • Senior Configuration Professional

    Humana (Albany, NY)
    …provisioning + EPIC analyst certification/accreditations as they related to business functions ( utilization management , care management , etc ) + Previous ... OR A Bachelor's degree - Areas of consideration are: Product Management , Health Informatics, Business, Computer Science, Engineering, or related + Strategic… more
    Humana (01/08/26)
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  • Behavioral Health Care Manager I - Ameriben

    Elevance Health (Latham, NY)
    …supervision.) **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad range of ... We are a third-party administrator (TPA) of medical benefits, including medical management . **Hours: 8am-5pm (Local time)** The **Behavioral Health Care Manager I**… more
    Elevance Health (01/07/26)
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  • Policy Governance Professional 2

    Humana (Albany, NY)
    …Policy Governance Professional 2 supports the ongoing development, review , and management of Utilization Management (UM) policies and procedures. This ... and continuous improvement initiatives. Responsibilities: + Assist with the development, review , and maintenance of UM policy and procedure documentation, ensuring… more
    Humana (01/08/26)
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  • Residential SUD Counselor - 127 West 25th Street

    Bowery Residents Committee (Manhattan, NY)
    …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 (12/30/25)
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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:** ... information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and… more
    Highland Hospital (12/02/25)
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  • Resource and Business Execution Senior Associate…

    Citigroup (Getzville, NY)
    …the Finance function. + **System Optimization:** Drive the optimization and effective utilization of headcount management systems and tools, working with IT ... Tool Utilization :** Leverage subject matter expert in relevant headcount management systems and tools, utilizing them effectively for data entry, reporting, and… more
    Citigroup (12/17/25)
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  • Space Manager

    City of New York (New York, NY)
    …with Facilities Management , Leasing, and Workplace Services teams on space management and utilization initiatives, and review opportunities to optimize ... City of New York and consists of six distinct units: Portfolio Planning and Management (PPM), Leasing, Design & Project Management (D&PM), Strategic Real Estate… more
    City of New York (01/08/26)
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  • Medical Director, Medical Policy

    Highmark Health (Albany, NY)
    …expertise.This may include updating/revising existing medical policies. + Partner with Utilization Management and other operational teams to identify ... by internal/external partners. Conducts peer reviews as part of the quality review process. In addition to policy ownership, the incumbent participates in various… more
    Highmark Health (12/24/25)
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  • RN, Clinical Document Spec

    University of Rochester (Rochester, NY)
    …Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management Work Shift: UR - Day (United States of America) ... knowledge of hospital clinical practice guidelines to support the most thorough review of the medical record. Other duties as assigned. **MINIMUM EDUCATION &… more
    University of Rochester (12/05/25)
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