- CVS Health (Albany, NY)
- …continuum of our members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing ... and socioeconomic needs. * Partner closely with the Executive Director of Duals and other Duals Care Management...and quality objectives are met. * Consults with plan medical staff regarding adverse determinations, addresses issues related to… more
- Humana (Albany, NY)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Albany, NY)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director actively uses their medical...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Albany, NY)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... in teams focusing on quality management , utilization management , case management , discharge planning...on size of region or line of business. The Medical Director conducts Utilization Management … more
- Acacia Network (Albany, NY)
- Camino Nuevo Medical Director Albany, NY : 3/19/2024 Job Description Job ID#: 3842 Job Category: Camino Nuevo Position Type: Full Time Details: POSITION ... OVERVIEW: The Medical Director engages in the professional, organizational,...+ Sharing in the administrative functions that directly impact medical services; collaborating with the management team… more
- Evolent Health (Albany, NY)
- …training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. ... Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Medical Director for the Musculoskeletal department, you will be a key member of… more
- J&J Family of Companies (Albany, NY)
- Director , Regulatory Medical Writing (1 of 4)...countries. Remote work options may be considered on a case -by- case basis and if approved by the company. ... - 2406211847W **Description** Johnson & Johnson is currently seeking a Director , Regulatory Medical Writing. The primary location for this position is the United… more
- Highmark Health (Albany, NY)
- **Company :** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care ... delivery and complex case management for our community-based palliative care...leadership and guidance to the regional interdisciplinary team. The medical director collaborates clinically with the APP… more
- Merck (Albany, NY)
- …systems accounts + Serves as a resource for the HSO MAD Team Lead, HSO Executive Director Medical Affairs, and other members of Country Medical Affairs on ... **Job Description** **Health Systems Oncology Medical Affairs Director , US Medical...This role also serves as a resource for the Medical Affairs (MA) management team on strategic… more
- Evolent Health (Albany, NY)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management ... Opportunities:** Evolent Health is looking for a Behavioral Health Medical Director to be a member of...in risk management , claim adjudication, pharmacy utilization management , catastrophic case review, outreach programs, +… more
- Humana (Albany, NY)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...experience post-training providing clinical services + Experience in utilization management review and case management … more
- Philips (Latham, NY)
- ** Medical Safety Director , Imaging** The Medical Safety Director is responsible for providing medical leadership across all aspects of medical ... life cycle; deep knowledge and understanding of all applicable standards/regulations requiring medical input, such as risk management , complaint management ,… more
- St. Catherine's Center for Children (Albany, NY)
- …disabled parents and/or mental health clients and/or their children; providing proactive, supportive case management . + Assist parents and their children in the ... and adults we serve. Function: Under the leadership and supervision of the Director of Prevention Services, the RACC Clinical Case Planner ("Planner") is… more
- Merck (Albany, NY)
- **Job Description** The Executive Director , Global Medical and Scientific Affairs (EDMA) GYN Malignancies is accountable for the development and execution of ... scientific & medical affairs Value and Implementation (V&I) plans for their...and Implementation (V&I) plan, in collaboration with the Executive Director of Scientific Affairs (EDSA), that guides TA scientific… more
- CVS Health (Albany, NY)
- …**Position Summary** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Cardiology) that can be remote based, work from home. This ... can be remote based anywhere in the US. The Medical Director (Cardiology) will be a Subject...will lead all aspects of utilization review/quality assurance, directing case management . In this role you will… more
- CVS Health (Albany, NY)
- …preferably resides in North Carolina and have a NC License without encumbrances.** In the Medical Director role you will provide oversight for medical policy ... evaluation of clinical/ medical programs and expand Aetna's medical management programs to address member needs...In addition you will oversee utilization review/quality assurance, directing case management . In this role you'll provide… more
- Sodexo (Albany, NY)
- **Unit Description** **Sodexo** has an opportunity for a **Senior** ** Director of Construction Management ** . This role leads the Project Management team ... renewal projects, capital improvement projects, energy projects, and construction management capabilities across Sodexo's full offer portfolio within the various… more
- Schenectady Community Action Program (Schenectady, NY)
- …to before recommending customer for subsequent emergency assistance. + Provide short term case management (90 days) and ensure support so customer's crisis is ... ameliorated. As directed provide long term case management and/or engage customer to long...exemption will be reviewed by the SCAP Human Resources Director and determined on a case by… more
- CVS Health (Albany, NY)
- …**This is a remote based (work at home) based anywhere in the US.** The Medical Director (Ortho/Total Joint) will be a Subject Matter Expert (SME) with a ... direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs...will lead all aspects of utilization review/quality assurance, directing case management . In this role you will… more
- Highmark Health (Albany, NY)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more