• 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 (03/04/25)
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  • Quality Assurance Senior…

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: The Utilization Review / Quality Assurance Sr. Coordinator will be responsible for providing clinical information to managed care companies as ... regulatory agencies, and other health care related entities. Preferred Qualifications: Utilization Review /Managed Care/ Quality Assurance experience.… more
    SUNY Upstate Medical University (03/10/25)
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  • Asst Utilization Coordinator - Appeals

    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 (03/04/25)
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  • Clinical Assessment Manager - Care Delivery

    CenterLight Health System (Flushing, 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 (04/26/25)
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  • Clinical Manager - Integrated Care Perm…

    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 (04/18/25)
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  • Clinical Assessment Manager

    Actalent (White Plains, NY)
    …(5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance , or discharge ... model. + Escalate questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of on-site… more
    Actalent (05/03/25)
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  • Clinical Assessment RN Manager - Bronx - Full-Time

    FlexStaff (Bronx, NY)
    …MAP, PACE, etc.). + 5+ years in case management, disease management, utilization review , or quality assurance . + Experience working with frail or elderly ... assessments using UAS-NY for prospective and enrolled PACE participants. + Review and update previous assessments, primary diagnoses, and medications in electronic… more
    FlexStaff (05/01/25)
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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 (03/30/25)
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  • Registered Nurse - OASAS

    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 (03/25/25)
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  • Full-time Utilization Review…

    St Joseph's Addiction Treatment & Recovery Centers (Saranac Lake, NY)
    …duties as directed by Supervisor, supporting the agency's mission and client care quality . Department Utilization Review Employment Type Full-Time Minimum ... Centers Location: Inpatient Facility - Saranac Lake, NY Position: Full-time Utilization Review Specialist Shift/schedule: Monday-Friday, 8:00am-4:30pm Pay Range:… more
    St Joseph's Addiction Treatment & Recovery Centers (04/15/25)
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