• Utilization Management

    Elevance Health (Latham, NY)
    Job Description **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates ... will live within 50 miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
    Elevance Health (01/15/25)
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  • Utilization Management Reprsentative…

    Elevance Health (Latham, NY)
    **Title: Utilization Management Representative II** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live ... within 50 miles of one of our PulsePoint locations. The ** Utilization Management Representative II** will be responsible for managing incoming calls,… more
    Elevance Health (01/15/25)
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  • Program Manager - Utilization

    Independent Health (Buffalo, NY)
    …perks, benefits and commitment to diversity and inclusion. **Overview** The Program Manager- Utilization Management (UM) will be accountable for the management ... recommendations for improvements to maintain an effective and efficient utilization management process, as well as manage...team and others as designated as the HCS department representative . _Immigration or work visa sponsorship will not be… more
    Independent Health (12/14/24)
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  • Rental Sales Representative

    Ryder System (Albany, NY)
    …of a dynamic team, equipped to succeed and empowered to develop your sales, management , operations, or customer service career. You thought that was it? Take a look ... your interest if you like what you read _** **Job Summary** The Rental Sales Representative is responsible for acting as the front-line sales agent for the rental of… more
    Ryder System (01/16/25)
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  • Member Service Representative - Full & Part…

    CDS Life Transitions (Webster, NY)
    …welcome calls to new members and document the contacts + Assist the Utilization Management Team by placing outbound calls for Service Approval notification ... benefits, please apply to find out more! Summary: A Member Services Representative is responsible for providing iCircle members with exceptional customer service. A… more
    CDS Life Transitions (01/27/25)
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  • Provider Relations Representative

    Molina Healthcare (Manhattan, NY)
    …example, such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding. * ... and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability… more
    Molina Healthcare (12/05/24)
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  • Member Service Representative

    CDPHP (Albany, NY)
    …invites you to be a part of that experience. The Member Service Representative shall assume full responsibility and ownership for all aspects regarding education of ... the member, the Employer Groups, Brokers and/or prospective members regarding the proper utilization of the Plan. In addition, the incumbent will address and resolve… more
    CDPHP (01/25/25)
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  • Financial Clearance Center Representative

    Catholic Health Services (Melville, NY)
    …is initiated within 24 hours of admission / arrival. Coordinate with onsite Case Management and Utilization Management to guarantee payer requirements are ... was named Long Island's Top Workplace! Job Details The Financial Clearance Representative works with the various components of the insurance verification, insurance… more
    Catholic Health Services (01/14/25)
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  • Service Sales and Rentals Representative

    Generac Power Systems (Bohemia, NY)
    …of Generac Power Systems, is seeking a Service Sales & Rentals Representative . This position will be responsible for increasing the rentals, aftermarket parts ... experience is required. **Work Experience:** + Building construction or existing facilities management sales experience required. + 1 year cold call via phone and… more
    Generac Power Systems (12/11/24)
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  • PA Office Support Representative

    Highmark Health (Albany, NY)
    …review and make determinations regarding physician reviewer assignments for medical management decisions. Cases requiring physician review are provider and member ... requests, received from Medical Management & Policy (MM&P) and Member Grievance Departments. * Responsible for management of Peer to Peer telephone line. Will… more
    Highmark Health (01/16/25)
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  • Customer Service Representative , Medicare…

    Molina Healthcare (Buffalo, NY)
    … (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/ Management staff work to ensure that Molina members, providers, and pharmacies have access to all… more
    Molina Healthcare (01/21/25)
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  • Regional Sales Representative (Long Island,…

    Envista Holdings Corporation (Farmingdale, NY)
    …account plans to support growth, provide implementation support to increase product utilization . + Increase market share through conversion of business clients to ... + Proficiency in professional selling and influencing skills and account management . + Dental industry or medical device experience preferred. + Strong… more
    Envista Holdings Corporation (01/17/25)
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  • Access Scheduler Representative - Day Shift

    Trinity Health (Syracuse, NY)
    …EQUIPMENT, SKILLS, OR OTHER REQUIREMENTS:** + Strong organizational and time management skills required. + Effective oral and written communication skills required. ... + Past experience in PC utilization required, with a proficient use of a Windows environment. **Mission Statement:** .We, St Joseph's Health and Trinity Health,… more
    Trinity Health (01/24/25)
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  • Director Patient Safety and Risk Management

    Bassett Healthcare (Cooperstown, NY)
    …of risk, safety, and patient grievance data. Organizes and implements the Risk Management and Patient Representative Services in a manner that supports the ... & Patient Experience, the Director of Patient Safety and Risk Management provides direct, day-to-day operational leadership for the development, implementation and… more
    Bassett Healthcare (11/19/24)
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  • Chief Medical Officer, Medicaid

    VNS Health (Manhattan, NY)
    …medical cases. Participates in the QARR/HEDIS Quality Improvement Activities and utilization management of the population. Works under limited direction. ... meet needs. + Provides guidance and consultative services to Utilization Management (UM) and Care Management...of care and member/provider satisfaction. + Acts as a representative of the VNS Health Plans and an advocate… more
    VNS Health (11/20/24)
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  • Account Manager/ Facilities Management

    CBRE (New York, NY)
    Account Manager/ Facilities Management (Financial Client)- NY, NY Job ID 201839 Posted 21-Jan-2025 Service line GWS Segment Role type Full-time Areas of Interest ... Facilities Management Location(s) New York City - New York -...and approval. Plans and monitors appropriate staffing levels and utilization of labor, including overtime. Prepares and delivers performance… more
    CBRE (01/22/25)
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  • SharePoint Developer (Information…

    CDM Smith (New York, NY)
    …maintain calendars and announcements, archive data, and manage SharePoint site space utilization . * Data Management : General understanding of data management ... mid-career professional with extensive experience in SharePoint design, development, and management , who is ready to take on increasing responsibilities with limited… more
    CDM Smith (01/09/25)
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  • Operations Management Trainee

    Ryder System (Rock Tavern, NY)
    …competitive advantage is our people. _CULTURE- INTEGRITY- FAMILY_ . As an **Operations Management Trainee** , you'll be part of a dynamic team, equipped to succeed ... been in the game since 1933! **Summary** The **Operations Management Trainee** will support the shop management ...+ Coordinate with the rental department to ensure maximum utilization without compromising lease customers. + Partner with Sales… more
    Ryder System (12/13/24)
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  • Registered Nurse Care Management Transition…

    Catholic Health (Buffalo, NY)
    …Care Manager, Transition of Care, as an active member of the Care Management and interdisciplinary care team, provides comprehensive case management and ... to patients and families in the hospital setting. Utilizing foundational case management and discharge planning principles, the RN Care Manager, Transition of Care… more
    Catholic Health (10/31/24)
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  • Clinical Pharmacy Manager - World Trade Center…

    Mount Sinai Health System (New York, NY)
    …will have direct patient responsibilities including both in-person and centralized management activities. Manager will work closely with the providers (MDs) and ... initiatives. This position is responsible for operationalizing goals related to the management of patient's medication access, oversight, and overall benefits at the… more
    Mount Sinai Health System (11/07/24)
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