• Utilization Management Reviewer, Licensed…

    Excellus BlueCross BlueShield (Rochester, NY)
    …position is responsible for coordinating, integrating, and monitoring the utilization of behavioral health ( BH ) services for members, ensuring compliance ... of services requested for the diagnosis and treatment of members' behavioral health conditions, applying established clinical review criteria, guidelines… more
    Excellus BlueCross BlueShield (11/19/25)
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  • Medical Director, Psychiatry (SafetyNet…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or ... physician. + Minimum 7 years of experience in a BH managed care settings or BH clinical...for business continuity. + Ability to travel across the Health Plan service region for meetings and/or trainings as… more
    Excellus BlueCross BlueShield (11/12/25)
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  • Medical Services Coordination Specialist I/II/III

    Excellus BlueCross BlueShield (Rochester, NY)
    …provides administrative support for any of the programs of Utilization Management, Behavioral Health , Quality Management, or Member Care Management. This ... members' specific contract benefits, consistent with products, policies and procedures and related health plan functions such as member services, claims , and the… more
    Excellus BlueCross BlueShield (10/21/25)
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