• Clinical Reviewer

    Independent Health (Buffalo, NY)
    …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical Reviewer will be responsible for the collection and review ... support of a high performing health plan and physician network. The Clinical Reviewer will investigate quality complaints/grievances and appeals, document… more
    Independent Health (10/07/25)
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  • Clinical Denials and Appeals-…

    Catholic Health (Buffalo, NY)
    …payers) and internal stakeholders including, but not limited to, Utilization Review , Case Management, Clinical Documentation Integrity, Health Information ... Acute Care Hospital Setting + Experience working within Utilization Review or Case Management or Clinical Documentation...within Utilization Review or Case Management or Clinical Documentation Integrity or + Experience in working with… more
    Catholic Health (10/01/25)
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  • Inpatient Clinical & Coding Specialist…

    Independent Health (Buffalo, NY)
    …coding guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records, consultation with ... and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist-Senior will be responsible for reviewing coding and … more
    Independent Health (10/04/25)
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  • Clinical Documentation Specialist

    Kaleida Health (Buffalo, NY)
    …Patient Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding data.The CDS facilitates ... ** Clinical Documentation Specialist** **Location:** **Larkin Bldg @ Exchange...care team. The CDS is also responsible for audit review to identify potential documentation deficiencies in specific records… more
    Kaleida Health (08/08/25)
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  • Clinical Lab Technologist Micro

    Catholic Health (Buffalo, NY)
    …communication. Familiarity with concepts, theories, and procedures of a clinical microbiology laboratory including microorganisms, their habitats, and their ... significance in clinical specimens. Clinical Laboratory Technologists may also...duties include operational functions such as patient and QC review , log sheet review , emergency scheduling, communications… more
    Catholic Health (07/23/25)
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  • Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    …and insurance / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG denial management required. **Working ... **Director Clinical and DRG Denials** **Location:** Larkin Bldg @...Full-Time **Shift:** Shift 1 Job Description **Summary:** The Director, Clinical & DRG Denials provides clinical leadership… more
    Kaleida Health (09/17/25)
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  • Clinical Operations Educator - RN

    General Physicians PC (Buffalo, NY)
    #25-0666 Buffalo, NY, USA Job Description RN - Clinical Operations Educator Join General Physician, PC - Your Gateway to a Fulfilling Nursing Career! Are you a ... Registered Nurse (RN) with a passion for clinical education and has experience in outpatient/doctors office settings? General Physician, PC, one of Western New… more
    General Physicians PC (07/22/25)
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  • Part Time Nursing Clinical Instructor

    Niagara County Community College (Sanborn, NY)
    Position Information Position Title Part Time Nursing Clinical Instructor Position Category Faculty Position Status FLSA Exempt Advertised Salary $860 per lab hour ... Niagara has an immediate need for part-time Nursing Instructors to teach in clinical areas of fundamentals (nursing home) 6.5 hours per week, Ortho/Neuro 12.5 hours… more
    Niagara County Community College (08/08/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Buffalo, NY)
    …identified by the Payment Integrity analytical team; requires decision making pertinent to clinical experience + Documents clinical review summaries, bill ... Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical... review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for review more
    Molina Healthcare (09/06/25)
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  • Clinical Lab Technologist Central Lab

    Catholic Health (Buffalo, NY)
    …while upholding guiding behaviors, standards and adherence to Core Values. Clinical Laboratory Technologists may also perform duties of Charge Technologists when ... upon provided they have six (6) years of experience as a Clinical Laboratory Technologist. Charge Technologist duties include operational functions such as patient… more
    Catholic Health (09/28/25)
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  • Clinical Lab Technologist MSMH

    Catholic Health (Lewiston, NY)
    …while upholding guiding behaviors, standards and adherence to Core Values. Clinical Laboratory Technologists may also perform duties of Charge Technologists when ... upon provided they have six (6) years of experience as a Clinical Laboratory Technologist. Charge Technologist duties include operational functions such as patient… more
    Catholic Health (08/15/25)
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  • Clinical Documentation Specialist HC

    Kaleida Health (Cheektowaga, NY)
    ** Clinical Documentation Specialist HC** **Location:** **Home Care-VNA Erie County** **Location of Job** **: US:NY:Cheektowaga** **Work Type** **: Full-Time** ... **Job Description** **Under direction of the department manager, this position completes review of OASIS documents, physician orders including the plan of care, as… more
    Kaleida Health (09/30/25)
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  • Clinical Laboratory Technologist Histology…

    Catholic Health (Buffalo, NY)
    …they have four (4) years of experience as a Clinical Laboratory Technologist/Histotechnologist. Charge Technologist duties include operational functions such ... as patient and QC review , log sheet review , emergency scheduling, communications...related discipline required CREDENTIALS + Must have valid NYS Clinical Laboratory Technologist license or Certified Histological Technologist or… more
    Catholic Health (10/08/25)
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  • PA Office Support Representative

    Highmark Health (Buffalo, NY)
    …the database for reporting purposes (20%) 3. Responsible to efficiently coordinate the clinical review process with contracted external review companies in ... Inc. **Job Description :** I. GENERAL OVERVIEW: * Receive, review and make determinations regarding physician reviewer ...clinical information * effective communication with the external review liaison to address questions or issues * The… more
    Highmark Health (10/07/25)
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  • Clinical Informatics Analyst (BI…

    Molina Healthcare (Buffalo, NY)
    **Job Summary** Reporting to the Director of Clinical Informatics for Analytics & Interfaces, the Clinical Informatics Data Analyst is responsible for the ... analyzing data to measure and monitor department initiatives. Additionally, the Clinical Informatics Data Analyst will actively participate in planning, developing,… more
    Molina Healthcare (10/11/25)
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  • Clinical Trial Coordinator II, FSP…

    ThermoFisher Scientific (Grand Island, NY)
    …site management in accordance with site SOPs and regulatory guidelines. **Role:** Clinical Study Coordinator **Location:** New York, NY **Please Note:** this is an ... systems. + Could assist with patient recruitment, identification, or chart review tasks. + Scheduling participant study visits, visit reminders, and diary… more
    ThermoFisher Scientific (10/04/25)
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  • Care Review Clinician LPN / LVN

    Molina Healthcare (Buffalo, NY)
    JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery… more
    Molina Healthcare (09/25/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Buffalo, NY)
    **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are ... medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated… more
    Molina Healthcare (10/02/25)
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  • Care Review Processor (Remote) PST Hours

    Molina Healthcare (Buffalo, NY)
    JOB DESCRIPTION Job SummaryProvides non- clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting ... * Provides telephone, clerical and data entry support for the care review team. * Provides computer entries of authorization request/provider inquiries, such as… more
    Molina Healthcare (10/09/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Buffalo, NY)
    …compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical ... in consistent and efficient manner. + Makes appropriate referrals to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care… more
    Molina Healthcare (09/05/25)
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