• Nurse Practitioner or Physician Assistant…

    Northwell Health (Manhasset, NY)
    …as a liaison to inpatient care team, anticipating barriers (ie, including prior authorizations, lab orders, and placement to subacute rehab facilities) and ... respiratory therapy and other ancillary services as needed + Coordinates and monitors prior authorizations, lab orders, testing, and discharge consults in a safe and… more
    Northwell Health (04/05/25)
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  • Pharmacy Resident

    KPH Healthcare Services, Inc. (East Syracuse, NY)
    …resident will possess knowledge on clinical account management, drug utilization management, data analysis, formulary management, and Medication Therapy Management ... clinical and cost savings programs for clients based upon review of utilization data, current trends, and industry offerings. Perform cost avoidance analysis to… more
    KPH Healthcare Services, Inc. (03/27/25)
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  • RN Case Manager - Case Management - Per Diem

    Guthrie (Corning, NY)
    …the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and other ... needs in collaboration with other clinical team members beginning when possible, prior to hospitalization (PAT, Joint Camp) and with the initial assessment and… more
    Guthrie (03/13/25)
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  • Financial Clearance Center Representative

    Catholic Health Services (Melville, NY)
    …system to secure authorizations for scheduled procedures requiring an authorization, prior to the date of service. Responsibilities: Utilize work queues/work drivers ... financial counseling when necessary. Collect co-payments, co-insurance, deductible and self-pay fees prior to or at the point of service. Documents collections in… more
    Catholic Health Services (04/15/25)
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  • Associate Director - Field Reimbursement…

    Bayer (Albany, NY)
    …area via supporting HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. ... State Medicaid, and Managed Plans; + Experience in educating and supporting Prior Authorization process, appeals, and denials; + Covermymeds - portal access… more
    Bayer (05/08/25)
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  • Clinical Pharmacy Specialist -Behavioral Health

    Veterans Affairs, Veterans Health Administration (Buffalo, NY)
    …mission, vision, and goals. The Pharmacist's primary responsibility is the utilization of evidence- based pharmaceutical care services through direct interactions ... subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested...###, or through their Web site at: http://www.acpe-accredit.org/. (NOTE: Prior to 2005 ACPE accredited both baccalaureate and Doctor… more
    Veterans Affairs, Veterans Health Administration (05/08/25)
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  • Advanced Medical Support Assistant

    Veterans Affairs, Veterans Health Administration (Bronx, NY)
    …Veteran-centered delivery of care. The AMSA will assist in ensuring clinic utilization is optimized and effectively supports the needs of the organization and ... the patient care team to review clinic [appointment availability] ( utilization ) [ ] to ensure that clinic [schedules are]...of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more… more
    Veterans Affairs, Veterans Health Administration (05/11/25)
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  • Full Time Licensed Social Worker

    Outreach Development Corporation (Brentwood, NY)
    …Complete all documentation (ie, progress notes, group notes, treatment plans, utilization reviews, progress reports to referents, thresholds, active caseload lists, ... to integrate and enhance clinical services. + Submit weekly schedules, ensure prior approval for offsite activities, monitor and enhance effective utilization more
    Outreach Development Corporation (05/10/25)
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  • Case Manager, RN or Licensed Behavioral Health…

    Excellus BlueCross BlueShield (Rochester, NY)
    …consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory ... of the Case Management department functions including quality, productivity, utilization performance, and educational needs to address established policies and… more
    Excellus BlueCross BlueShield (05/10/25)
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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 population. + ... interpretation. + Develops and implements the BH sections of the Quality Management/ Utilization Management (QM/UM) Plan, including having the BH Medical Director for… more
    Excellus BlueCross BlueShield (05/10/25)
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