• RN Unit Manager - Taylor Health

    Arnot Health (Bath, NY)
    …the philosophy and objectives of the Long Term Care Department. + Ensures the utilization of the nursing process in maintaining quality of standards of practice and ... standards of care. + Develops leadership skills of staff and delegates responsibility appropriately. + Demonstrates appropriate problem solving and decision making skills. + Assists in responding to staff regarding grievance and problems and refers them to… more
    Arnot Health (07/28/25)
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  • Practice Manager I Podiatry

    Finger Lakes Health (Geneva, NY)
    …internal and external customers. Coordinates activities of the office. Directs and guides staff and ensures appropriate utilization of human and capital resources.na ... Acts as liaison with companies, carriers, and internal departments to insure delivery of services and accurate billing. Overall responsibility for providing other administrative functions of the department. Maintains effective verbal and written communications… more
    Finger Lakes Health (07/24/25)
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  • Technical Product Manager

    S&P Global (NY)
    …+ Establish guidelines and best practices for GenAI solution design and utilization , driving innovation and efficiency. + Conduct market research to identify ... emerging technologies and trends in GenAI and cloud-native applications. + Provide technical expertise and mentorship to the product management team, fostering a culture of innovation and technical excellence. **Compensation/Benefits Information (US Applicants… more
    S&P Global (07/20/25)
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  • Patient Services Associate - Mobile Health

    Project Renewal, Inc. (New York, NY)
    …related survey instruments as directed. + Communicate with the Mobile Operations Manager on current site utilization . + Participates in departmental meetings ... - Friday 9am - 5pm Program Overview: Reporting to the Mobile Operations Manager , the Mobile Health Patient Services Associate is responsible for working in… more
    Project Renewal, Inc. (09/27/25)
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  • Pharmacist, Clinical/Medication Therapy Management…

    Molina Healthcare (Syracuse, NY)
    …authorization requests as needed. * Researches, develops, and implements drug utilization and disease state management strategies and intervention techniques to ... staff, and providers. * Reviews and analyzes Pharmacy Benefit Manager (PBM) reports to track general trends in drug... (PBM) reports to track general trends in drug utilization and identify potential targeted utilization management… more
    Molina Healthcare (09/24/25)
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  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …optimal patient outcomes in the expected time frame and with most efficient utilization of resources. Carries out activities related to utilization management, ... base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay reviews and assists with managing the length of… more
    Rochester Regional Health (07/25/25)
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  • Clinical Denials and Appeals-Clinical Supervisor

    Catholic Health (Buffalo, NY)
    …payers) and internal stakeholders including, but not limited to, Utilization Review, Case Management, Clinical Documentation Integrity, Health Information ... Certified Coder (CPC/CCS), Certified Processional Medical Auditor (CPMA), Certified Case Manager (CCM) or any other certification approved by management +… more
    Catholic Health (10/01/25)
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  • RN Lead, Healthcare Services

    Molina Healthcare (Buffalo, NY)
    …supporting one or more of the following functions: care management, utilization management, care transitions, long-term services and supports (LTSS), behavioral ... at least 2 years of managed care experienced in utilization management * Registered Nurse (RN) ONLY if required...and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification… more
    Molina Healthcare (09/26/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (Yonkers, NY)
    …Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and ... as may be required. + Serves as a clinical resource for Utilization Management, Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. + Provides… more
    Molina Healthcare (09/26/25)
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  • Director Physician Advisor

    Catholic Health Services (Melville, NY)
    …+ Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical documentation. + ... Advisors during the monthly Physician Advisor meeting. + Attends hospital Utilization Management (UM) committees. + Supervises the Facility Physician Advisors. +… more
    Catholic Health Services (09/26/25)
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