• Physician- Associate Chief of Staff - Mental…

    Veterans Affairs, Veterans Health Administration (Montrose, NY)
    …goals for eligibility, referral and authorization, care coordination, and utilization management to ensure improved Veteran experience. Makes recommendations for ... improving the Veteran's experience and outcomes. Defines mental health policies, utilization management process and procedures, financial and utilization reports… more
    Veterans Affairs, Veterans Health Administration (05/22/25)
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  • Registered Nurse Care Manager Transition of Care…

    Catholic Health (Kenmore, NY)
    …EXPERIENCE + Two (2) years acute care and/or community health nursing + Preferred prior insurance /managed care/ utilization review experience in the role of a ... Case Manager or Disease Manager, Population Health, Discharge Planning or Chronic Care Manager KNOWLEDGE, SKILL AND ABILITY + Possesses case management skills critical to working on an interdisciplinary team + Has a good understanding of the Social… more
    Catholic Health (07/04/25)
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  • Registered Nurse Care Management Transition…

    Catholic Health (Buffalo, NY)
    …Management preferred + Two (2) years acute care RN experience required + Preferred prior insurance /managed care/ utilization review experience in the role of a ... Case Manager or Disease Manager, Population Health, Discharge Planning or Chronic Care Manager KNOWLEDGE, SKILL AND ABILITY + Possesses case management skills critical to working on an interdisciplinary team + Has a good understanding of the Social… more
    Catholic Health (07/02/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …provided by the Case Manager include, but are not limited to, utilization review, case management, care transition, collaboration with physicians and social workers ... experience in a hospital environment preferred. + Previous case management, utilization review, and discharge planning experience highly preferred. Home care, payer,… more
    Ellis Medicine (06/12/25)
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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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  • Director of Case Management

    Stony Brook University (Stony Brook, NY)
    …will play a critical role in improving patient outcomes, optimizing resource utilization , and ensuring the delivery of high-quality care. This individual will work ... Case Management leadership and staff functions related to case management and utilization management activities. + Manage and mentor a team of case managers,… more
    Stony Brook University (06/24/25)
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  • Social Worker- Multi Visit Patient Program

    SUNY Upstate Medical University (Syracuse, NY)
    …and community-based partners to develop strategies to decrease unnecessary hospital ED utilization . In this position, the social worker will Identify utilization ... knowledge of social determinants, population health and drivers of utilization . Duties will include consultation through assessment, counseling, intervention,… more
    SUNY Upstate Medical University (05/18/25)
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  • Clinical Pharmacy Specialist (Critical…

    Veterans Affairs, Veterans Health Administration (Bronx, NY)
    …Pharmacy Specialist functions as a therapeutic expert in drug use and drug utilization . The incumbent monitors drug use, makes recommendations on the correct ... utilization of drugs, exercises duties as outlined in their...subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested… more
    Veterans Affairs, Veterans Health Administration (07/22/25)
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  • Advanced Medical Support Assistant

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    …Selecting the specific codes is necessary for the accuracy of collecting utilization management data. The AMSAs are responsible for changing providers in the ... care in the community by ensuring all required documentation is completed by prior to transfer VHA directive for Interfacility Transfers, as well as ensures complies… more
    Veterans Affairs, Veterans Health Administration (07/24/25)
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  • Sr Analyst, Scope Management

    Evolent (Albany, NY)
    …informatics professionals who work with national health plans to ensure that prior authorization and financial coding stay accurate, compliant, and aligned with ... Management plays a crucial role in supporting the comprehensive management of prior authorization and financial scope within Evolent Specialty Services. Reporting to… more
    Evolent (07/18/25)
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