• Utilization Review Specialist

    Amergis (Albany, NY)
    Salary: $52 / Hour The Utilization Review Specialist is responsible for theassessment and review of the healthcare delivery system with a concentration ... + A Bachelor's Degree in Nursing or at least two years'experience in Utilization Review preferred + Certification in Utilization Review or… more
    Amergis (10/10/25)
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  • Mental Health Program Specialist 2, Central…

    New York State Civil Service (Albany, NY)
    …adolescents with mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review . ? The ideal candidate(s) ... Agency Mental Health, Office of Title Mental Health Program Specialist 2, Central Office; Occupational Category Other Professional Careers...will have direct care and utilization management experience, including familiarity with the … more
    New York State Civil Service (09/27/25)
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  • Mental Health Program Specialist 2, Central…

    New York State Civil Service (Albany, NY)
    …adolescents with mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review . ? The ideal candidate(s) ... Agency Mental Health, Office of Title Mental Health Program Specialist 2, Central Office; Occupational Category Other Professional Careers...will have direct care and utilization management experience, including familiarity with the … more
    New York State Civil Service (09/27/25)
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  • Mental Health Program Specialist 2, Central…

    New York State Civil Service (Albany, NY)
    …adolescents with mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review . ? The ideal candidate(s) ... Agency Mental Health, Office of Title Mental Health Program Specialist 2, Central Office; Occupational Category Other Professional Careers...will have direct care and utilization management experience, including familiarity with the … more
    New York State Civil Service (09/27/25)
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  • Mental Health Program Specialist 2, Central…

    New York State Civil Service (Albany, NY)
    …adolescents with mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review . ? The ideal candidate(s) ... Agency Mental Health, Office of Title Mental Health Program Specialist 2, Central Office; Occupational Category Other Professional Careers...will have direct care and utilization management experience, including familiarity with the … more
    New York State Civil Service (09/27/25)
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  • Denials Prevention Specialist PRN

    Datavant (Albany, NY)
    …tools. The specialist serves as a key liaison between coding, billing, utilization review , case management, and payer relations to reduce denials and improve ... and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the… more
    Datavant (10/08/25)
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  • Mental Health Program Specialist 2, Central…

    New York State Civil Service (Albany, NY)
    …HELP Yes Agency Mental Health, Office of Title Mental Health Program Specialist 2, Central Office; Occupational Category Other Professional Careers Salary Grade 23 ... Office of Mental Health (OMH) is seeking qualified candidates to a Mental Health Program Specialist 2 - G 23 position in the Division of Community Program Policy &… more
    New York State Civil Service (10/03/25)
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  • Medicaid Integrity Specialist 1/Trainee…

    New York State Civil Service (Albany, NY)
    …Medicaid Integrity Specialist 1 position will support the Division of System Utilization and Review , Bureau of Third Party & Payment Oversight, RAC unit. ... Inspector General, NYS Office of the Title Medicaid Integrity Specialist 1/Trainee 1/Trainee 2 (NY HELPS) Occupational Category No...service, or 55 b/c service as a Medicaid Integrity Specialist 1; OR current New York State employee with… more
    New York State Civil Service (09/30/25)
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  • Internal Medicine Health & Science System…

    Pfizer (Albany, NY)
    …and patients in this dynamic ecosystem. The Health and Science System Specialist (HSSS) is responsible for launching new products, deciding on optimal strategies ... of strong leadership, cross functional leadership, collaboration, and effective utilization of available resources to drive performance. + Strong organizational… more
    Pfizer (10/05/25)
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  • Clinical Support Specialist

    CDPHP (Latham, NY)
    …invites you to be a part of that experience. The clinical support specialist (CSS) provides administrative support to clinical staff within Member Health. The CSS ... (2) years experience in a health insurance related discipline required. + Utilization management experience is preferred. + Knowledge of managed care, health plan… more
    CDPHP (10/05/25)
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  • Registered Nurse - Clinical Appeals & Denials…

    Cognizant (Albany, NY)
    …and retro-authorization as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral, preauthorization, medical ... necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and third-party… more
    Cognizant (10/09/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Albany, NY)
    utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
    Evolent (07/30/25)
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  • Manager, Credentialing

    University of Rochester (Albany, NY)
    …compliance monitoring, including but not limited to, monitoring of health review requirements (OSHA), professional license, DEA, sanctions, NPDB, complaints, and ... options available to the industry at large. + Oversees the Credentials Privilege Review , Committee and Board Approval Process. Supervises the departmental review more
    University of Rochester (08/25/25)
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  • Supervisor Employee Services Contact Center…

    Ryder System (Albany, NY)
    _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... (Tier 1 Call Center Representatives and Tier 2 Functional Specialist ). Ensure contact center staff have the training and...to get things done regardless of obstacles + Optimized utilization of resources to provide a delightful and consistent… more
    Ryder System (09/24/25)
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  • AIX Administrator

    ASM Research, An Accenture Federal Services Company (Albany, NY)
    …on the project in a senior administrator capacity. Considered a technical specialist in a variety of IT administrator disciplines. + Configure, monitor, and ... as needed (aside from on-call rotation). + Optimize system operations and resource utilization as well as perform system capacity analysis and planning. + Utilize… more
    ASM Research, An Accenture Federal Services Company (08/22/25)
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