Utilization Manager Jobs in New York
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Search Results - Utilization Manager Jobs in New York
Tandym Health-New York-
appropriate health care utilization management (UM).
Responsibilities:
• Reviews cases, determines medical necessity, and consults with physicians to review length of stay and reimbursement documentation
• Supports the Utilization Management (UM) department...
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MJHS-New York-
with appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners. Assures appropriate staffing to support departmental/agency services. Ensures all employees are oriented to their department/agency and job...
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Pharmacy Benefit Management-New York-
and Utilization Management functions. This role plays a critical part in ensuring DC 37 members receive timely, appropriate, and evidence-based access to medications in accordance with the Plan document, formulary, and applicable clinical guidelines.
The Prior...
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Integrated Home Brand-New York-appcast.io-
of timely, evidence-based decisions aligned with payer policy, regulatory requirements, and best clinical practices. The ideal candidate will closely collaborate with utilization management, care coordination, and provider-network engagement teams to support...
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MJHS-New York-
with appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners. Assures appropriate staffing to support departmental/agency services. Ensures all employees are oriented to their department/agency and job...
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Bleuler Psychotherapy Center-New York-
Maintain audit readiness and regulatory compliance across all documentation and service areas
• Approve schedules, review PTO coverage, and ensure consistent client access to care
• Participate in case reviews, utilization management, IRC meetings...
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Sagility-New York-
Qualifications
• RN license in an eNLC (Enhanced Nurse Licensure Compact) state with multistate privileges
• 3+ years Nursing experience
• 1+ years’ Utilization Management experience
• Familiarity with medical terminology, utilization management guidelines...
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New York-vnshealth.org-
Overview:
Directs the Utilization Management department operations and programs across all product lines in VNS Health Plans Participates in the development of the departmental strategic goals and objectives consistent with the overall VNS Health...
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NavitasPartners-New York-talentnest.com-
is seeking an experienced Registered Nurse (RN) – Case Management to coordinate patient care, manage healthcare resources, and support utilization management to ensure appropriate and cost-effective treatment. The RN will collaborate with multidisciplinary...
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Robotics technology LLC-New York-jobvertise.com-
on progress, risks, and outcomes. Squad Management: should have hands on experience in Squad Management, Estimation Management, Resource Utilization Management Qualifications: Experience: 10+ years in technical program management, preferably in financial...
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SuperDial-New York-
or payer operations teams.
• Strong understanding of payer operations, including claims processing, utilization management, prior authorization, and member services workflows.
• Experience managing complex, multi-stakeholder enterprise sales cycles...
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New York-vnshealth.org-
oral and written communication skills Required
Advanced personal computer skills, including Word, Excel or Access Required
Utilization Management experience Preferred
Pay Range: USD $20.98 - USD $26.23 /Hr....
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NavitasPartners-New York-talentnest.com-
Candidates: $2,400 per week
Position Overview
A healthcare facility in New York is seeking an experienced Registered Nurse – Case Manager to support patient care coordination, resource management, and utilization...
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New York-icims.com-
in resource deployment and utilization management.
• Strong social skills, with the ability to interact optimally at various levels.
• Successfully operates in a fast-paced driven environment that requires the ability to handle several tasks simultaneously...
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New York-vnshealth.org-
Reconciles and validates underlying analytic data claims, and utilization management systems. Tests the integrity of utilization and payment data across plans and functions. Engages in activities to support corrective actions to functions, Operations...
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