• Primary Care Physician (PCP)

    STG International (Kingston, NY)
    …safety. + Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... THIS IS FOR A FUTURE OPENING STGi is currently seeking a Primary Care Physician to provide services at our Community Based Outpatient Clinic. JOB SUMMARY: The… more
    STG International (10/08/25)
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  • Primary Care Physician (PCP) - PRN

    STG International (Auburn, NY)
    …safety. * Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... STGi is currently seeking a Primary Care Physician to provide services at our Community Based...Performance Improvement Team (QPIT) strategic initiatives. * Participate in review and improvement of clinical success in of areas… more
    STG International (09/26/25)
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  • Physician Assistant

    BriteLife Recovery (West Kill, NY)
    …Maintain compliance with regulatory, licensing, and accreditation standards (eg, audits, utilization review , quality assurance). + Participate in performance ... Physician Assistant Do you work for a company...place to work. What you will be doing? The Physician Assistant (PA) at Britelife Recovery plays a critical… more
    BriteLife Recovery (10/19/25)
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  • Medical Director, Medical Management

    Highmark Health (Albany, NY)
    …DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the multidisciplinary team ... Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in… more
    Highmark Health (10/28/25)
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  • Care Review Processor (Remote) PST Hours

    Molina Healthcare (Buffalo, NY)
    JOB DESCRIPTION Job SummaryProvides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting ... * Provides telephone, clerical and data entry support for the care review team. * Provides computer entries of authorization request/provider inquiries, such as… more
    Molina Healthcare (10/18/25)
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  • Case Mgr, RN Casual- Case Management

    Northwell Health (Staten Island, NY)
    …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. * Keeps ... concurrent utilization management using Interqual criteria. * Conducts chart review for appropriateness of admission and continued length of stay. * Contacts… more
    Northwell Health (10/21/25)
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  • Medical Director, Psychiatry (SafetyNet…

    Excellus BlueCross BlueShield (Buffalo, NY)
    … management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review , quality ... physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization of… more
    Excellus BlueCross BlueShield (08/09/25)
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  • Remote Medical Director

    Centene Corporation (New York, NY)
    …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization of… more
    Centene Corporation (08/16/25)
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  • Nurse Practitioner-Cardiothoracic- Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …interprets the clients responses to the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion but not less than ... to established standards as part of initial orientation and annual performance review with collaborating physician or appropriately credentialed designee. +… more
    Mount Sinai Health System (11/02/25)
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  • RN/Case Manager-MSH-Case Management-FT-Days

    Mount Sinai Health System (New York, NY)
    …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager ... are not limited to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more
    Mount Sinai Health System (10/29/25)
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