• Pharmacy Coordinator

    Highmark Health (Albany, NY)
    …Wholecare's pharmacy programs with a focus on medication adherence and optimizing member health outcomes. This role involves a high volume of daily contacts with ... address medication-related issues, promote adherence, and ensure appropriate medication utilization . **ESSENTIAL RESPONSIBILITIES** + Communicate effectively with physicians and… more
    Highmark Health (09/19/25)
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  • Pharmacy Benefit Consultant

    Highmark Health (Albany, NY)
    …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year ... **Substitutions** + 6 years experience in pharmacy or managed health care setting in lieu of Bachelor degree **Preferred**...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (08/26/25)
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  • Manager Software Engineering - AI Platforms…

    Highmark Health (Albany, NY)
    **Company :** Highmark Health **Job Description :** Entirely Remote Work From Anywhere Role! We are seeking an experienced Software Engineering Manager to lead our ... have budgetary responsibility and authority. + Understand budget and resource utilization across the product teams. Escalate any issues regarding product delivery… more
    Highmark Health (08/08/25)
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  • Psychologist 2 (NY Helps)

    New York State Civil Service (Claverack, NY)
    …in experimental psychology, research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance ... Family Services, Office of Title Psychologist 2 (NY HELPS) Occupational Category Health Care, Human/Social Services Salary Grade 23 Bargaining Unit PS&T -… more
    New York State Civil Service (10/02/25)
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  • 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)
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  • RN Lead, Healthcare Services

    Molina Healthcare (Buffalo, NY)
    … utilization management, care transitions, long-term services and supports (LTSS), behavioral health , and other clinical programs, and collaborates with ... * Actively participates in the department auditing program to review , communicate findings and identify opportunities for improved quality...every work day and cases are addressed to maintain health rid assessment (HRA) and care plan compliance. *… more
    Molina Healthcare (09/26/25)
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  • Healthcare Services Operations Support Auditor

    Molina Healthcare (Yonkers, NY)
    …* Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Utilization management, care management, behavioral health ... to subsequently resolve/correct. Required Qualifications * At least 2 years health care experience, preferably in utilization management, care management,… more
    Molina Healthcare (09/28/25)
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  • AVP of OR/Peri-Op Services

    Albany Medical Center (Albany, NY)
    …development of its strategic plan. Education: + A Master's Degree in health , business, education or related field. Licensure, Certification & Registration: + Must ... Responds to changes in work efficiently and effectively. Support implementation and utilization of clinical nursing research. Promote the use by colleges and… more
    Albany Medical Center (09/27/25)
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  • Substance Misuse Counselor - ON4009 - Mon-Fri…

    WellLife Network (Bronx, NY)
    …to build trust with clients. + Knowledge of addiction treatment models and behavioral health interventions. + Crisis intervention skills to handle emergencies. + ... Description About WellLife Network: WellLife Network is a leading health and human services organization dedicated to supporting individuals...participant needs and update program plan and / or utilization of review plans. + Represent the… more
    WellLife Network (08/07/25)
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  • Psychologist Reviewer

    Centene Corporation (New York, NY)
    …in New York. **Position Purpose:** Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information ... necessity and appropriateness of care + Conduct peer reviews with psychologists, behavioral health therapists and/or Board Certified Behavior Analysts for… more
    Centene Corporation (09/05/25)
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