2mo
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Director, Utilization Management
New York, New York, United States
$155k-$237k/yr OnsiteFull Time
Senior-level leadership in utilization management with healthcare regulatory knowledge.
1mo
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Utilization Management Nurse Registered
Woodland Park or Paterson
$49-$74/hr OnsiteFull Time
3+ YOEBachelor of Science in Nursing, NJ RN license, minimum 3 years nursing experience; 3+ years utilization review or case management preferred; CCM preferred.
1mo
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RN Utilization Review Specialist
Nyack, New York, United States
$110k/yr OnsiteFull Time
4+ YOENY registered nurse required; performs utilization management, discharge planning, concurrent reviews using Interqual, documents medical necessity, coordinates care across team; 4-6 years clinical experience preferred.
Interqual, Care Management database, H/C PRI/Screen
2mo
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Senior Manager, Utilization Management
New York, New York, United States
OnsiteFull Time
6+ YOE3+ MgmtBachelor's degree plus RN license; 6+ years in Utilization/Case Management/Appeals within managed care; 3+ years of leadership; Milliman guidelines knowledge; strong decision-making, communication, and MS Office skills.
Microsoft Office
1mo
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Placement & Utilization Support Coordinator
New York, New York, United States
$41k-$45k/yr HybridFull Time
1+ YOE1 year customer service experience required; healthcare experience preferred. Familiarity with utilization/case management, HealthRules Payor, Microsoft Word and Excel, 55 wpm typing, and strong customer service and interdisciplinary teamwork skills.
HealthRules Payor, Microsoft Word, Microsoft Excel
1mo
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Placement & Utilization Support Coordinator
New York, New York, United States
$41k-$45k/yr OnsiteFull Time
1+ YOE1 year customer service experience required; healthcare experience preferred. Familiarity with utilization/case management, HealthRules Payor, Microsoft Word and Excel; typing 55 wpm; strong customer service and interdisciplinary teamwork skills.
HealthRules Payor, Microsoft Word, Microsoft Excel
2mo
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CHS Utilization and Appeals Manager
Melville, New York, United States
$110k-$150k/yr OnsiteFull Time
5+ YOERN with 5+ years clinical/appeals experience; strong knowledge of utilization and care management; proficient in EPIC/Midas/Star; excellent communication and regulatory understanding.
EPIC, Midas, Star
2mo
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CHS Utilization and Appeals Manager
Melville, New York, United States
$110k-$150k/yr OnsiteFull Time
5+ YOERN with 5+ years in clinical utilization/care management and appeals; managed care experience; EPIC/Midas/Star familiarity; NY RN license; BSN preferred.
EPIC, Midas, Star, Word processing, Spreadsheet
2mo
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Utilization Review Assistant
New York, New York, United States
$27-$34/yr OnsiteFull Time
3+ YOEAdministrative support in healthcare; HS diploma or GED with 3 years experience or associate degree; strong organization; proficient in MS Office and EHR; excellent communication.
Microsoft Word, Excel, Electronic Health Records, Outlook
1mo
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Utilization Review Nurse- Care Coordination Department
Poughkeepsie, New York, United States
$48-$74/hr HybridFull Time
3+ YOEActive NY RN license, Associate degree in nursing, 3+ years acute/subacute nursing experience, utilization management experience preferred, proficiency with Cerner, InterQual/MCG knowledge, CCM/ACM preferred, NYS PRI required within 60 days, HIPAA compliance.
Cerner, InterQual, MCG
2w
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Manager of Utilization Review and Case Management Professional Development
Patchogue, New York, United States
$85k-$128k/yr OnsiteFull Time
NYS registered nurse license required; experience coordinating utilization review, discharge planning and resource management; proficiency with EPIC, CarePort, Indicia, MCG, Microsoft PowerPoint, Excel and Word; education and staff development experience.
EPIC, CarePort, Indicia, MCG, Microsoft PowerPoint, Microsoft Excel, Microsoft Word
1w
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Director of Utilization Management
New York City or New Jersey or Connecticut
$118k-$133k/yr HybridFull Time
3+ YOE5+ MgmtMinimum 5 years management in health-related field, 3 years quality management, Bachelor's required (Master's preferred), active NYS RN license or willing to obtain within 3 months, experience analyzing data and knowledge of Medicare/Medicaid quality regulations.
4w
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Utilization Management Specialist-MSH-Case Management-FT-Days
New York, New York, United States
$23-$34/hr OnsiteFull Time
2+ YOEAssociates degree or equivalent (Bachelors preferred), 2+ years relevant experience, coordinating payer communications, denial management, data entry into tracking/EMR systems.
EMR
4w
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Utilization Management Specialist-MSH-Case Management-FT-Days
New York, New York, United States
$23-$34/hr OnsiteFull Time
2+ YOEAssociates degree or equivalent (Bachelors preferred), 2+ years relevant experience, experience with EMR and data entry, payer authorization and denial management skills, strong communication.
Microsoft Office Suite, EMR
3w
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OP Enforcement Manager
New York or New York
$160k-$170k/yr OnsiteFull Time
7+ YOEBachelor's in electrical or power system engineering,7+ years utility experience in planning or operations,PE or NERC operator cert preferred,ability to assess risk and communicate technical findings.
Microsoft Office
2mo
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Utilization Review and Appeals Case Manager
Stony Brook, New York, United States
$90k-$128k/yr OnsiteFull Time
4+ YOERN with 3-5 years acute care; NY RN license;Bachelor's degree; knowledge of InterQual/MCG; strong communication; proficient in Word/Excel; weekend flexibility
Microsoft Word, Microsoft Excel, PowerPoint, Electronic Medical Records (EMR)
3d
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Field Service Representative (Water Utility, U355)
Merrick, New York, United States
$38/hr FieldFull Time
High school diploma/GED, valid driver's license, ability to lift over 25 lbs, work outdoors in varied weather, computer literate and able to learn mobile work management and meter reading equipment.
SAP, Mobile Work Management Program, meter reading equipment
2mo
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Associate Medical Director, Utilization Management
New York or Florida or Arizona or North Carolina
$240k-$315k/yr RemoteFull Time
3+ YOEBoard-certified MD or DO with unrestricted license, 3+ years clinical practice, 2+ years utilization review experience, ability to manage physicians, and willingness to obtain state licensure; strong documentation and clinical judgment.
1w
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Mechanic Helper
Norwalk, Connecticut, United States
$33/hr FieldFull Time
3.5+ YOEH.S. diploma or GED, 3.5+ years gas-related field experience, EEI CAST test for external candidates, ability to obtain/maintain CDL, able to work on-call and respond to emergencies.
1mo
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Senior Data Scientist - Utilization Management
Wellesley or New York
$102k-$222k/yr HybridFull Time
3+ YOE3+ years analytic experience; programming in R or Python; experience with SQL; strong algorithm and predictive modeling knowledge; experience with LLMs/Generative AI preferred; bachelor’s degree or equivalent.
R, Python, SQL, LLMs, Generative AI
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