• Utilization Review / Quality…

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: The Utilization Review / Quality Assurance Coordinator is responsible for all compliance related paperwork and ensures all compliance ... paperwork is completed in a timely manor for the Upstate/Syracuse City School District school-based mental health care program. This position helps ensure successful visits by DNV and OMH when they occur. Monitors and maintains performance improvement… more
    SUNY Upstate Medical University (06/03/25)
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  • Asst Utilization Coordinator

    WMCHealth (Valhalla, NY)
    …hospital or health care agency, one of which must have been in the area of utilization review , quality assurance , risk management or discharge planning. ... the implementation or investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester… more
    WMCHealth (07/01/25)
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  • Remote Medical Director

    Centene Corporation (New York, NY)
    … quality improvement activities. + Performs medical review activities pertaining to utilization review , quality assurance , and medical review ... + Provides medical expertise in the operation of approved quality improvement and utilization management programs in...with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends… more
    Centene Corporation (07/03/25)
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  • Clinical Manager - Integrated Care Perm / Brooklyn…

    FlexStaff (New York, NY)
    …(5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance , or discharge ... delivery model. Escalates questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of… more
    FlexStaff (07/18/25)
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  • Clinical Assessment Manager - Care Delivery

    CenterLight Health System (NY)
    …(5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance , or discharge ... model. + Escalates questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of on-site… more
    CenterLight Health System (07/11/25)
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  • Medical Director - New Jersey Market

    CVS Health (Albany, NY)
    …As a Medical Director you will focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews ... is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This is a remote based… more
    CVS Health (07/10/25)
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  • Hannick RN Supervisor

    Catholic Charities Family Community Services (Newark, NY)
    …and other record keeping as necessary for program accountability + Participates in monthly Utilization Review , quality assurance and program evaluation ... activities as directed. + Coordinates discharge planning for clients + Provides education to clients on health and wellness issues. + Participates in staff meetings and clinical supervision as directed + Actively pursues development of professional… more
    Catholic Charities Family Community Services (06/11/25)
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  • CMSU Research Quality Assurance…

    University of Rochester (Rochester, NY)
    …and testing of clinical products and packaging components to pre-approved specifications. Quality Assurance Review and Verification of Production Operations: ... to act with minimal guidance in the areas of review and approval of critical documents; SOP's, Process Orders...handle responsibilities of a more complex nature within the Quality Assurance function of Clinical Materials Services… more
    University of Rochester (07/16/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …program's efforts to track, review , and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis ... quality of care and/or life. + Performs quality assurance activities to include: + Provides...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
    Helio Health Inc. (07/11/25)
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  • RN, Quality Assurance

    University of Rochester (Rochester, NY)
    …preferred - Clinical chart review and abstraction experience preferred - Quality Assurance and Process Improvement (QA/PI) experience preferred LICENSES AND ... the application of strict inclusion/exclusion criteria and protocols. Performs meticulous chart review and enters clinical data into the quality databases to… more
    University of Rochester (07/19/25)
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