• Social Worker - Inpatient Behavioral Health

    Garnet Health (Harris, NY)
    …Case Manager for the detox patient on the medical floor assuring discharge planning, utilization review , and insurance approval. Join the Garnet Health team and ... your career home with us as a Social Worker on our Inpatient Behavioral Health Unit (BHU) team at/in Garnet Health Medical Center-Catskill. Responsibilities The… more
    Garnet Health (08/26/25)
    - Related Jobs

  • Field Care Manager - Behavioral Health

    Healthfirst (NY)
    …out of home placement, and/or community-based services and may be called upon to do Utilization Review for those services + Develops care plans that align with ... + Applies care management principles by advocating, informing, and educating beneficiaries...principles by advocating, informing, and educating beneficiaries on services, self- management techniques, and health benefits related to the continuum… more
    Healthfirst (09/27/25)
    - Related Jobs

  • Care Review Clinician, Prior Authorization

    Molina Healthcare (Albany, NY)
    …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with PEGA helpful. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
    Molina Healthcare (09/18/25)
    - Related Jobs

  • Care Review Clinician, PA (RN)

    Molina Healthcare (Rochester, NY)
    …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
    Molina Healthcare (09/05/25)
    - Related Jobs

  • Manager, Healthcare Services

    Molina Healthcare (Buffalo, NY)
    …integrated) performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical ... an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high...years in one or more of the following areas: utilization management , case management , care… more
    Molina Healthcare (09/27/25)
    - Related Jobs

  • Disease Management Nurse - Remote

    Sharecare (Albany, NY)
    …change techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
    Sharecare (09/13/25)
    - Related Jobs

  • Psychologist 1/2 - Long Island EOA#: 2025-364

    New York State Civil Service (NY)
    …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... of target behaviors, to provide treatment for target behaviors* Review and analyze behavior data* Provide individual counseling and...was a substantial diminution of the emotional, social, or behavioral condition of an individual who was a witness… more
    New York State Civil Service (10/01/25)
    - Related Jobs

  • Mental Health Program Specialist 2, Central…

    New York State Civil Service (Albany, NY)
    …mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review . ? The ideal candidate(s) will have ... Outpatient Services. In addition, the Unit supports Certified Community Behavioral Health Clinics and other integrated care programming. Under...direct care and utilization management experience, including familiarity with the review … more
    New York State Civil Service (09/27/25)
    - Related Jobs

  • Social Worker II

    Ellis Medicine (Schenectady, NY)
    …plan, implement and evaluate individual healthcare needs. Integrate Discharge Planning, Utilization Review and Performance Improvement activities at the patient, ... levels. Efficiently and effectively anticipates, identifies and resolves issues through utilization review and discharge planning processes. Collaborates with… more
    Ellis Medicine (09/23/25)
    - Related Jobs

  • 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 ... in nursing, involving perioperative and/or procedural services + Demonstrated progressive management experience, minimum 3-5 years Skills, Knowledge & Abilities: +… more
    Albany Medical Center (09/27/25)
    - Related Jobs