utilization manager jobs in New York

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and professional development by conducting regular 1:1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements. The...

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and professional development by conducting regular 1:1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements. The...

Duties/Responsibilities:Provides case management services for assigned member caseloads which includes:Pre-certification – performing risk-identification, preadmission, concurrent, and retrospective reviews to evaluate the appropriateness and medical necessity of treatments and service utilizations based on clinical documentation, regulatory, and...

The Case Manager, Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, and case management as assigned. The Case Manager, Utilization Management is also responsible for efficient utilization of health services and optimal health outcomes for members, as well as meeting...

Position SummaryThe Manager of Utilization Management provides daily oversight for Case Management teams (which includes RN’s, Social Workers, and Coordinators). The Manager of Utilization Management is responsible for ensuring high quality, cost-effective, and appropriate allocation of member services, treatments, and resources. The Manager of Utilization...

Job DescriptionOverviewWe are seeking a Project Manager, Utilities to join our team in Rochester NY or Binghamton, NY.Your roleEffective leadership in a matrix organization.Initiation, Planning, Executing, and Closing Projects - defining the project WBS, Cost Baseline and OBS structure, initiating the project, building its comprehensive work plan,...

At Perrigo, we are driven by our mission to Makes Lives Better Through Trusted Health and Wellness Solutions, Accessible to All . We are proud to be a Top 10 player in the European Consumer Self-Care market and the largest U.S. store brand provider of over the counter and infant formula. Dedicated to providing The Best Self-Care for Everyone , we are...

Manager - Utility Transmission PlanningAt Jacobs, we're challenging today to reinvent tomorrow by solving the world's most critical problems for thriving cities, resilient environments, mission-critical outcomes, operational advancement, scientific discovery and cutting-edge manufacturing, turning abstract ideas into realities that transform the world for...

Healthfirst is seeking a Manager of Utilization Management in New York to oversee Case Management teams including RNs, social workers, and coordinators, ensuring quality, cost-effective, and appropriate member care. The role collaborates with medical staff, analyzes utilization data, and maintains documentation in EMR systems while supporting the care...

Utilization Management Nurse As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to...

AtkinsRéalis is seeking a Project Manager for utilities to lead large-scale projects in Rochester or Binghamton, NY. You will drive initiation, planning, execution, and closing, building work plans and controlling risks, scope, and budget.You will oversee teams and third-party coordinations across transmission domains. Required 5–10 years in utility...

Metropolitan Jewish Health System, Inc. is seeking a Supervisor to oversee the MLTC/DSNP pre-authorization functions and ensure regulatory compliance. The role directs staff, reviews case complexity, and maintains interdepartmental communication to support efficient operations.The ideal candidate has nursing credentials, management experience, and...

Pape-Dawson Engineers seeks a Project Manager in Houston to support Municipal Utility Districts within the District Services group. You will coordinate capital improvement planning, regulatory compliance, and infrastructure development, working with Land Development and Facilities teams to deliver projects on time and on budget. Ideal candidates bring a PE...

hackajob is collaborating with Accenture to connect them with exceptional professionals for this role. We Are: Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen...

Job title: Project Manager (Utility or energy industry)Location: Long Island, NYPosition: PermanentJOB DESCRIPTIONCLIENT needs a Project Manager serving in a programmatic leadership role for a mission critical utility facility with extensive IT and OT system requirements.This pivotal role involves managing dynamic teams supporting customers both on-site and...

At Perrigo, we are driven by our mission to Makes Lives Better Through Trusted Health and Wellness Solutions, Accessible to All . We are proud to be a Top 10 player in the European Consumer Self-Care market and the largest U.S. store brand provider of over the counter and infant formula. Dedicated to providing The Best Self-Care for Everyone , we are...

COPE Health Solutions is seeking a qualified Utilization Management Nurse (RN) to assess member needs, determine medical necessity and coordinate care across providers and care teams. This full-time, remote position reports to Medical Management and focuses on timely, cost-effective decision-making. Responsibilities include prior authorizations, case...

Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state and federal regulations. Delivers timely...

Paycom is seeking a Safety Manager to lead the development and oversight of safety programs and site-specific Health and Safety Plans (HASP) across utility, infrastructure, and construction operations.The role collaborates with operations, project teams, and clients to promote a culture of safety, reduce incidents, and drive continuous improvement. Strong...

# Clinical Pharmacist, PBM Utilization ManagementPharmacy Benefit Management (PBM)Denver, ColoradoAugust 18, 2026$130,000 - $155,000 / yearFull TimeApplication ends: **September 25, 2026**Apply Now### Job Description**Location:** Denver, CO (Onsite)We are seeking a **Clinical Pharmacist, PBM Utilization Management** to develop utilization management...