• Utilization Management Specialist

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
    Mount Sinai Health System (10/03/25)
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  • Commercial Review Specialist I

    SUNY Upstate Medical University (Syracuse, NY)
    …including PC, Windows, Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, ... Job Summary: The UR-CR Specialist I is primarily responsible for ensuring that...reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria… more
    SUNY Upstate Medical University (11/18/25)
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  • Insurance Specialist

    Trinity Health (Syracuse, NY)
    …college level course in medical terminology.One year of case management or utilization review /billing or coding experience.One year of experience in ... coding/medical records/billing or healthcare related fieldOne year of case management or utilization review , billing, or coding experiencePlease be aware for the… more
    Trinity Health (11/05/25)
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  • Denials Prevention Specialist , Clinician…

    Datavant (Albany, NY)
    …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical ... well versed in DRG downgrade denials and appeal writing for inpatient admission . Experience with clinical criteria resources and payor guidelines. **You will:** +… more
    Datavant (11/12/25)
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  • Senior Clinical Staff Specialist

    Rochester Institute of Technology (Rochester, NY)
    **9779BR** **Position Title:** Senior Clinical Staff Specialist **Organization:** Student Health Center **Job Responsibilities:** + Patient Care Services & Clinical ... delegated by the Administrative Supervisor: + Create Master Templates + Manage, review and adjust daily appointment schedules; use independent judgement to address… more
    Rochester Institute of Technology (11/01/25)
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  • Quality Management Specialist I

    DePaul (Rochester, NY)
    …follow-up consultation and training. + Responsible for Utilization Record Review functions to include Individual record audits, admission reviews, continued ... Overview The Quality Management Specialist works with the Quality Management Department to provide the highest achievable quality of services to the individuals we… more
    DePaul (10/10/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    … regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, ... appropriateness of admission and continued stay, severity, and morbidity/mortality. + Review patient status when admission criteria is non-sufficient for … more
    Mohawk Valley Health System (10/07/25)
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  • Academic Administrator II

    University of Rochester (Rochester, NY)
    …directly to the Senior Manager of Student Affairs, the Student Support Specialist plays a vital role in supporting students in workforce investment programs, ... through data collection, evaluation, and stakeholder engagement. The Student Support Specialist also oversees all mandatory student compliance items for new and… more
    University of Rochester (10/08/25)
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  • Data Analyst I

    University of Rochester (Rochester, NY)
    …**ESSENTIAL FUNCTIONS** Registry Abstraction: + Accurately identify all trauma admissions , transfers, and deaths, using clinical identifiers and strict ... Attend registry vendor sponsored training workshops/meetings to maximize trauma registry utilization and performance. Registry Admin Duties + Oversee the conversion,… more
    University of Rochester (11/05/25)
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  • Certified Recovery Peer Advocate (Crpa)

    BriteLife Recovery (West Kill, NY)
    …functions. + Under direction of supervisor, establish appropriate therapeutic boundaries, utilization of identified clinical resources to review boundaries, ... We are seeking a passionate and qualified Certified Recovery Specialist (CRS) to join our dynamic team. The CRS...a database (EMR). + Ability to explain and complete admissions paperwork. + Ability to complete the admissions more
    BriteLife Recovery (11/24/25)
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