• Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    …conventions and insurance / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG denial management required. ... Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full -Time **Shift:** Shift 1 Job Description **Summary:** The Director, Clinical & DRG… more
    Kaleida Health (09/17/25)
    - Related Jobs

  • Treatment Team Leader Developmental Disabilities

    New York State Civil Service (Masonville, NY)
    …policy, treatment, and therapeutic programs, and serves on committees such as placement, utilization review , medical records review , and related committees, ... Pathologist 2, Teacher 4 (and all parenthetics), Training Specialist 1 (Nursing), and Utilization Review Coordinator. Additional Comments * If you are currently… more
    New York State Civil Service (10/31/25)
    - Related Jobs

  • Registered Nurse Case Manager II - Home Care

    Rochester Regional Health (Rochester, NY)
    …+ Practices according to Agency and community standards + Participates in utilization review and/or continuous quality improvement activities as requested. + ... the patient (and their caregivers as applicable), in collaboration with the attending physician and other care team members + Manages and coordinates patient care,… more
    Rochester Regional Health (09/23/25)
    - Related Jobs

  • Occupational Therapist

    WMCHealth (Kingston, NY)
    …NY Category: Allied Health Prof/Technical Department: Physical Therapy Union: No Position: Full Time Hours: T-S Shift: Day, Evening Req #: 40053 Posted Date: ... functional evaluation of the client; conducts the planning and utilization of a program of purposeful activities; implements the...be rendered on the prescription or referral of a physician , nurse practitioner or other health care provider acting… more
    WMCHealth (09/12/25)
    - Related Jobs

  • Clin. Documentation Specialist

    WMCHealth (Valhalla, NY)
    …and coding principles and guidelines; good knowledge of healthcare delivery system, utilization review , case review and quality improvement practice ... NY Category: Professional/Non-Clinical Department: Health Info Mgmt-WMC Health Union: No Position: Full Time Hours: Mon,Tues,,Wed,Sat & Sunday Shift: AM Req #: 44453… more
    WMCHealth (10/17/25)
    - Related Jobs

  • Nurse Manager, Ambulatory Services

    Rochester Regional Health (Rochester, NY)
    …with Directors of Nursing and Director of Quality to provide quality review activities. Guides assigned areas in utilization of recognized improvement ... Surgery Service Line. Works collaboratively with operational leadership and physician leadership to develop budgets based on volumes and...representation of current potential base pay for a successful full time applicant. It may be modified in the… more
    Rochester Regional Health (10/14/25)
    - Related Jobs

  • Associate Medical Director - Sleep Medicine

    Elevance Health (New York, NY)
    …Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit Management/ Utilization Review ** **Virtual:** This role enables associates ... to work virtually full -time, with the exception of required in-person training sessions,...case reviews for their board certified specialty. + Makes physician to physician calls to gather medical… more
    Elevance Health (10/28/25)
    - Related Jobs

  • Clinical Reviewer

    Independent Health (Buffalo, NY)
    …**Overview** The Clinical Reviewer will be responsible for the collection and review of medical records specific to quality complaints/grievances and appeals as ... indicated in support of a high performing health plan and physician network. The Clinical Reviewer will investigate quality complaints/grievances and appeals,… more
    Independent Health (10/07/25)
    - Related Jobs

  • Process Manager, Anesthesiology

    Rochester Regional Health (Rochester, NY)
    …+ Work with teams to define project scope and deliverables. + Develop full scale project plans and associated communication documents. + Coordinate meetings with ... etc. + Provide data and analysis related to supply utilization . + Integrate data from multiple systems/sources for process...EVS to schedule annual maintenance of the departments. + Review weekly all open facilities work orders and work… more
    Rochester Regional Health (10/10/25)
    - Related Jobs

  • RN - Women's Health Office

    Albany Medical Center (Albany, NY)
    …Day (United States of America) Salary Range: $83,200.00 - $128,960.00 Registered Nurse - Full Time Women's Health Office Work schedule: Monday - Friday Albany, NY We ... compassionate patient care. Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
    Albany Medical Center (10/25/25)
    - Related Jobs