• Utilization Review Nurse

    CDPHP (Latham, NY)
    …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and ... for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality… more
    CDPHP (09/23/25)
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  • CHS Utilization and Appeals Coordinator

    Catholic Health Services (Melville, NY)
    …timely follow through. + Reviews providers' requests for services and coordinates utilization /appeals management review . + Assist Utilization and Appeals ... as a liaison between patient account services, physicians, care coordinators, Utilization and Appeals Managers, physician advisors and facility departments.… more
    Catholic Health Services (09/09/25)
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  • Utilization Management Reviewer, RN…

    Excellus BlueCross BlueShield (Rochester, NY)
    …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… more
    Excellus BlueCross BlueShield (10/07/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional information if the ... the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration...of discharge plan + Collaborates and makes referrals to physician advisor when unable to resolve issues with attending… more
    Ellis Medicine (10/24/25)
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  • Temporary Behavioral Health Utilization

    CDPHP (Latham, NY)
    …for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality ... to be a part of that experience. The BH Utilization Specialist is responsible for coordination of care for...Certified Case Manager (CCM) designation preferred. + PRI (Patient Review Instrument) certification preferred. + Minimum one (1) year… more
    CDPHP (10/16/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …specialist regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, ... billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of...and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides… more
    Mohawk Valley Health System (10/07/25)
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  • Director Physician Advisor

    Catholic Health Services (Melville, NY)
    …Initiatives + Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical ... presents to Physician Advisors during the monthly Physician Advisor meeting. + Attends hospital Utilization ...+ Certification by American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. 4. Knowledge,… more
    Catholic Health Services (09/26/25)
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  • Physician Assistant-Qhc-13601-006

    Mount Sinai Health System (Jamaica, NY)
    …Description** Under the general supervision of a licensed and Board-Certified Physician , evaluates and treats adult patients having medical, psychiatric, and/or ... patient care. **Qualifications** -Bachelor of Science or Master's degree in Physician Assistant Studies. Additional education/experience may be required for some… more
    Mount Sinai Health System (10/14/25)
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  • OR Program Director/ Physician Associate…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Exciting Opportunity for OR-Experienced Physician Assistants!** Join The Mount Sinai Hospital and become an operational leader. Gain hands-on ... with this incredible opportunity! The Program Director is a credentialed Physician Assistant (PA), responsible for daily operations of _all_ surgical sub-specialties… more
    Mount Sinai Health System (09/17/25)
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  • Director Physician Practice Operations CMH

    UHS (Norwich, NY)
    …for patient/provider phone calls. + Creates a system for monitoring clinic utilization , workload vs. billing, and individual physician provider productivity on ... Position OverviewThe Director of Physician Practice Operations is responsible for the workflow...you grow wherever your passion leads. We also continuously review compensation to ensure market competitiveness and internal equity,… more
    UHS (10/21/25)
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