• Utilization Management

    Excellus BlueCross BlueShield (Rochester, NY)
    …encourage you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and ... outbound calls to customers (members and providers) by delivering excellent customer-centered service providing information regarding services in a call center… more
    Excellus BlueCross BlueShield (05/29/25)
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  • Health Insur & Auth Rep III

    University of Rochester (Rochester, NY)
    …of Medicare and other payer regulations for the coordination of benefits. + Notify Utilization Management of clinical requests by third party payers. + Maintain ... Counseling, Medicaid Enrollment & Outreach, Financial Assistance, Registration and Insurance Management , Utilization Management , Social Work, Patient… more
    University of Rochester (05/29/25)
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  • Guest Services Rep III

    University of Rochester (Rochester, NY)
    …Time Type: Part time Scheduled Weekly Hours: 20 Department: 500059 Ambassador and Guest Services Work Shift: UR - Day (United States of America) Range: UR URCB 203 ... **Responsibilities:** GENERAL PURPOSE: With general direction of the Ambassador Management Team and with latitude for independent initiative and judgment:… more
    University of Rochester (06/06/25)
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  • Clinical Manager School Based

    Hillside Family of Agencies (Rochester, NY)
    …of the day-to-day operations of the program, including hiring, training, fiscal management , utilization management , clinical oversight and regulatory ... SUMMARY The Clinical Manager ensures the delivery of quality services to youth and their families by providing guidance...within budget parameters. + Ensures program consistently achieves budgeted utilization and works with team to address any … more
    Hillside Family of Agencies (06/21/25)
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  • Hospital Admissions Rep IV

    University of Rochester (Rochester, NY)
    …arranges for admission of patients to inpatient and outpatient beds and services , schedules and assigns accommodations or service locations; determines financial ... internal equity considerations._ **Responsibilities:** GENERAL SUMMARY Using excellent customer service skills and exercising thorough knowledge of hospital policy… more
    University of Rochester (06/02/25)
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  • Physician Support Rep III

    University of Rochester (Rochester, NY)
    …when needed. Maintains and updates cancellation/wait lists to effectively manage utilization . Answers phones, triages calls and relays messages. Fields patient ... independently. Maintains and updates cancellation/wait lists to effectively manage utilization . Ensuring clinics are appropriately full and operating efficiently.… more
    University of Rochester (04/07/25)
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  • Senior Provider Relations Representative

    Molina Healthcare (Rochester, NY)
    …example, such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding. * ... that services Molina members, including but not limited to Fee-For- Service and Pay for Performance Providers. It is an external-facing, field-based position… more
    Molina Healthcare (06/15/25)
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  • Hospital Admissions Rep IV

    University of Rochester (Rochester, NY)
    …on more complex assignments. **ESSENTIAL FUNCTIONS** + Interprets eligibility for admission/ service /treatment plans. + Documents in a timely, accurate manner in the ... urgent admissions. + Marks patients for merge and notifies Health Information Management . + Exercising tact, initiative and independent judgment based on financial… more
    University of Rochester (06/10/25)
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  • Registration&Insur Mgt Rep III

    University of Rochester (Rochester, NY)
    …**Responsibilities:** GENERAL PURPOSE: Performs the functions of patient account management for individuals receiving services . Completes the tasks ... requesting deposits, initiating referrals to sponsorship programs. Coordinates account management through discharge and forwards accounts to the patient accounting… more
    University of Rochester (04/07/25)
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  • Customer Service Representative

    Molina Healthcare (Rochester, NY)
    …requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy services (such as, therapeutic drug monitoring, ... **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 (06/25/25)
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  • Physician Support Representative III

    University of Rochester (Rochester, NY)
    …preparations for providers, including but not limited to time and calendar management while optimization of provider patient schedule, coordination of patient care ... the time and effort of providers by reviewing reports such as Clinic Utilization , Master Templates and the volume of Referrals. + Develops, enforces and continuously… more
    University of Rochester (06/04/25)
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  • RESTART Intake & Case Management Specialist

    Catholic Charities Family Community Services (Rochester, NY)
    …Day **Description** Under general supervision, provides intake support, ongoing case management and referral coordination services to residential clients. ... **RESTART Intake & Case Management Specialist** **Job Details** **Job Location** Jones House...Coordinates with Intake Manager regarding bed utilization . Effectively supports ongoing and collaborative communication amongst all… more
    Catholic Charities Family Community Services (06/25/25)
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  • Client Services Manager, Environment…

    Eurofins (Buffalo, NY)
    service facing teams to include but not limited to Sample Receiving, Service Centers and Project Management staff. The Manager is responsible for cohesion ... courier services , TALs sample login and client receipt resolution. " Service Center" as referenced throughout the document which include every aspect of… more
    Eurofins (06/04/25)
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  • Vice President Residential Treatment…

    Hillside Family of Agencies (Rochester, NY)
    …mission-driven leader responsible for the overall strategic, operational, and financial management of the organization's residential treatment services - ... and support a culture of continuous improvement, evidence-based practices, and service excellence across residential treatment services . + Stakeholder… more
    Hillside Family of Agencies (05/02/25)
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  • Account Service Consultant I/II…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …products, services , and policies in accordance with MTM, Corporate Service strategy, NCQA, and legislative requirements. + Responds to sales/retention team ... initial account setup, benefit books, summaries, contracts, etc. + Services brokers, consultants, and employer groups supporting a mix...and improvement. + Attends meetings and/or trainings as a representative of the Account Service Team and… more
    Excellus BlueCross BlueShield (06/24/25)
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  • Registered Nurse Care Management Transition…

    Catholic Health (Buffalo, NY)
    …the Care Management and interdisciplinary care team, provides comprehensive case management and discharge services to patients and families in the hospital ... setting. Utilizing foundational case management and discharge planning principles, the RN Care Manager,...RN Care Manager, Transition of Care engages the patient/patient representative in developing and implementing a post hospital plan… more
    Catholic Health (06/26/25)
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  • Foster Care and 29I Liaison

    OLV Human Services (Lackawanna, NY)
    …liaison/coordinator 2. Will attend all meetings with OCFS to discuss enrollment numbers, utilization of services , denials and issues with managed care plans. 3. ... Care & 29I Liaison will work in collaboration with applicable OLV Human Services staff members to carry out the responsibilities within our Foster Care contracts… more
    OLV Human Services (06/22/25)
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  • Operations Management Trainee - Fleet…

    Ryder System (Rochester, NY)
    …to train!** **This job requires a 4-year college degree** **Summary** The **Operations Management Trainee** will support the shop management process and assist ... requires the Manager Trainee to work cross functionally across Operations, Asset Management , Sales, Quality, and Rental Management . This program is fast-paced… more
    Ryder System (04/15/25)
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  • Sr. Operational Buyer

    Edwards Vacuum, LLC (Buffalo, NY)
    …environment and experience of working with suppliers of engineering products and services . - Operational/engineering management experience and knowledge of wide ... US dry pump manufacturing and maintains continuity of supply to maximize service levels. Continuously improve processes used to plan/buy inbound material to reduce… more
    Edwards Vacuum, LLC (06/24/25)
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  • Human Resources Manager- US

    The Gleason Works (Rochester, NY)
    …Corporation is a leader in gear technology. Gleason's product and service offerings include gear and transmission design software, gear manufacturing machines ... within the US locations, including Payroll, Benefits, Recruitment, Performance Management and compliance. Essential Job Functions & Responsibilities: + Ownership… more
    The Gleason Works (04/24/25)
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