• Mgr Health Insurance & Prior Authorization…

    University of Rochester (Rochester, NY)
    Utilization Management, Social Work, Patient Accounts, Medical Records, Home Care Coordinators, Prior Authorization Teams, Contracting and Finance. + Works ... Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500183 Health Insurance Counseling Work Shift: UR - Day (United States of America)… more
    University of Rochester (08/07/25)
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  • Director of Care Coordination

    Catholic Health Services (West Islip, NY)
    …with Hospital Conditions of Participation. Implements care management programs, including utilization review , intake and discharge planning. Evaluates patient ... collaboratively with, but not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals, Managed Care and Revenue Cycle and Patient… more
    Catholic Health Services (07/18/25)
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  • Behavioral Health Service Provider

    OLV Human Services (Lackawanna, NY)
    …electronic health record (EHR) for documentation of services rendered. + Review utilization and service provision with supervisor + Coordinate and ... schedule. To learn more about programs that include Behavior Health Service Provider jobs, click here: https://www.olvhs.org/hcbs-children- home -and-community-based-services… more
    OLV Human Services (06/06/25)
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  • Public Health Navigator, Bureau of Maternal…

    City of New York (New York, NY)
    …a timely manner. - Support marketing and outreach activities to increase visibility and utilization of the CI&R system and home visiting programs. - Participate ... Job Description Public Health Adviser II-51191 Open to candidates who are...vision by supporting and promoting breast/chest-feeding, infant safety, and home visiting services to pregnant and parenting families. DUTIES… more
    City of New York (05/23/25)
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  • Field Medical Director, Cardiology

    Evolent (Albany, NY)
    utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
    Evolent (07/02/25)
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  • Field Medical Director-Vascular Surgery

    Evolent (Albany, NY)
    utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
    Evolent (08/03/25)
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  • Field Medical Director, MSK (Spine) Surgery

    Evolent (Albany, NY)
    utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
    Evolent (07/02/25)
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  • Medical Director- South Central

    Humana (Albany, NY)
    …quality management, utilization management, case management, discharge planning and/or home health or post-acute services (such as inpatient rehabilitation). ... insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization,… more
    Humana (07/11/25)
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  • Care Delivery Manager

    CenterLight Health System (Ridgewood, NY)
    …+ Minimum of 2 years of administrative experience in a management capacity in a certified home health agency (CHHA), long-term home health care (LHCSA), ... health care needs and goals to support in attaining and maintaining optimal health status. + Collaborate with clinicians to review UAS and the UAS analyzer… more
    CenterLight Health System (08/08/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Albany, NY)
    …, Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review , medical policy/procedure development, provider contracting experience. + Experience ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
    Molina Healthcare (08/08/25)
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