- 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 ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Albany, NY)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Humana (Albany, NY)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Medical Director , Behavioral Health, Child & Adolescent Programs will conduct utilization ... services across all lines of business. In addition, the Medical Director will be assigned to oversee...Excel, Outlook and PowerPoint is required. + Knowledge of claims management systems is preferred. + Ability… more
- Cardinal Health (Albany, NY)
- …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Sedgwick (Albany, NY)
- …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Client Services Director - Casualty | CST & EST Time Zones...EST Time Zones **PRIMARY PURPOSE** : To determine account management strategies related to client service plans; to be… more
- Takeda Pharmaceuticals (Albany, NY)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Trinity Health (Albany, NY)
- …Administration **OPERATIONS/COMPLIANCE:** Collaborates with the Risk Manager and/or the Regional Director of Risk Management to facilitate the deployment & ... identify witnesses, schedule interviews, depositions and other discovery). In litigated claims , assists Trinity Health Insurance and Risk Management Services… more
- HomeSafe Alliance (Albany, NY)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- Evolent Health (Albany, NY)
- …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
- New York State Civil Service (Albany, NY)
- …care services, prior approval or authorization activities, adjudication or pricing of claims for payment, or analysis of patterns of health care. 3. Overseeing ... capitation reimbursement methodologies, fee schedule development, coding constructs for medical goods and services, or application and processing of reimbursement… more
- Northern Rivers Family Services (Albany, NY)
- …+ Collaborate with in-house staff regarding concerns and behaviors. + Communicate with medical director and providers regarding changes in client's health and ... House, and Residential Treatment Center programs. You will report to the Executive Director of Nursing and will work onsite. Sign-On Bonus / Relocation Assistance… more
- Intermountain Health (Albany, NY)
- …a liaison in order to facilitate the prompt resolution of complex benefit, claims or enrollment issues for external, internal and team contacts. Handles service ... the task resolution process in Salesforce by utilizing task management with other departments and complaint tasks to seek...Assists in the design of marketing literature for unique medical and dental plans. SALES SYSTEMS: Is committed to… more
- Fujifilm (Albany, NY)
- …limited management oversight. The position will report to the Director of Corporate Compliance. **Duties and responsibilities** + Develop and implement elements ... needs of healthcare across prevention, diagnosis, and treatment. Fujifilm's medical imaging portfolio includes solutions for digital radiography, mammography,… more
- New York State Civil Service (Albany, NY)
- …researching applicable law, and case documents.* Communicate, discuss, and explain to Claims Department staff the basis for rejections of appeal requests;* Preparing ... Appeals Unit Manager is absent for extended periods;* Assisting the Legal Appeals Director by reviewing and analyzing selected Board Panel and Full Board decisions… more