- Elevance Health (Morristown, NJ)
- ** Director I Medicare Operations ** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of ... and Medicaid Services to transform federal health programs. The ** Director I Medicare Operations ** is responsible for directing multiple business function… more
- Mount Sinai Health System (New York, NY)
- …The team includes 400+ employees with clinical, contracting, finance, IT, analytics, operations , and product development expertise. MSHP is a fast growing business ... the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1)...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …unmet areas in Immunology and Oncology. MTPA is rapidly expanding its operations across all functional areas. MTPA's commitment to patients and their communities ... with assigned specialty distributor and specialty pharmacy accounts. The Associate Director of Trade will collaborate with members of Supply Chain, Commercial,… more
- CVS Health (New York, NY)
- …Process Insights and Reengineering (APIR) team is functional unit of the Medicare Member Experience organization that engages with various business areas to mine ... As a key member the APIR team, the Lead Director will be expected to: + Serve as a...states. + Establish qualitative and quantitative connections between the Medicare member journey and the underlying business processes and… more
- Mount Sinai Health System (New York, NY)
- …is responsible for evaluating and driving performance for value-based contracts including Medicare , Medicaid and commercial arrangements. The Senior Director is ... for value-based contracts inclusive of risk and opportunity identification for Medicare , Medicaid and Commercial arrangements. 2. Develop strategies and alternatives… more
- FlexStaff (New York, NY)
- **Req Number** 138917 FlexStaff is seeking a Regional Medical Director for our client, a non-profit healthcare organization providing home and community-based ... Under the direction of the Chief Medical Officer, the Regional Medical Director is responsible for the professional, organizational, and administrative aspects of… more
- City of New York (New York, NY)
- …for (1) Administrative Staff Analyst NM III to function as an Executive Director , Data Analytics & Verification who will: - Oversee the management, administration, ... and data sharing methods and/or tools that drive DSS-AO operations , and other Agency program areas (eg FIA, MICSA,...work includes identifying Medicaid clients who should apply for Medicare , identifying Medicaid clients who should be part of… more
- WelbeHealth (Brooklyn, NY)
- …them living safely in their communities. Reporting to the Chief Clinical Officer, the Medical Director will be at the center of an IDT, providing care. PACE is an ... to promote quality and outcome goals. + Monitor and lead WelbeHealth clinic operations to assure integration of medical services with other participant care services… more
- Option Care Health (College Point, NY)
- …data to the Regional Nurse Manager, Area Director of Nursing, and/or Director of Operations . Supports the development and implementation of the Plan of ... direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also...office specific continuing education and orientation programs. Assists the Director of Operations , Area Director … more
- Centers Plan for Healthy Living (Staten Island, NY)
- …a fast-paced environment + Managed long-term care knowledge + Medicaid knowledge + Medicare knowledge SCOPE INFORMATION # Direct Reports: Director Training and ... The Training Coordinator works directly with Trainer/Auditors and reports to the Director of Training and Development. The primary objective is to provide overall… more
- Molina Healthcare (New York, NY)
- …education, outreach and resolving provider inquiries. * In conjunction with the Director , Provider Network Management & Operations , develops health plan-specific ... managed healthcare administration experience. * Specific experience in provider services, operations , and/or contract negotiations in a Medicare and Medicaid… more
- VNS Health (Manhattan, NY)
- …VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Ensures regulatory compliance, timeliness requirements and ... accuracy standards are met. Coordinates efficient functioning of day-to-day operations according to defined processes and procedures. Creates and maintains accurate… more
- VNS Health (Manhattan, NY)
- …following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA) or Select Health. Ensures compliance with state and federal ... Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Part D, or Select Health to...including but not limited to, Provider Relations, Claims, Medical Director , third party administrator, pharmacy benefit manager, to achieve… more
- City of New York (New York, NY)
- …Manager who will, under the general direction of the Excess Income/Surplus Director , with wide latitude for the exercise of independent initiative and judgment ... Excess Income's Under-care renewals, Pay-In, e-Faxe, Provider Bills, Constituent inquiries, Medicare Saving Program (MSP) and Pooled Trust units. Receive cases from… more
- BronxCare Health System (Bronx, NY)
- …etc. - Maintain and update policies and procedures for site with the Medical Director . - Analyze all aspects of practice operations to identify deficiencies with ... clinical/administrative department. This position is responsible for general office operations , filing, organizing and overall administrative performance. The Office… more
- Fresenius Medical Center (Bronx, NY)
- …dialysis clinics, hospitals and physician(s), to address any concerns/ issues Facility Operations + Participate in Governing Body Meetings; included but not limited ... + Provide support to the Medical Executive Committee as requested by the Medical Director and in accordance with the Medical Staff Bylaws. + Maintain compliance with… more
- St. Joseph's Health (Paterson, NJ)
- …and state rules and regulations, DNV accreditation standards, and Centers for Medicare and Medicaid (CMS) Conditions of Participation relative to the practice of ... pharmacy within the health system. Collaborates with the Director , other managers, supervisors, clinical pharmacists, and pharmacists who are responsible and… more
- Mount Sinai Health System (New York, NY)
- …of experience in a clinical healthcare environment. Experience in clinical operations and/or experience working in performance improvement, patient safety, risk ... - MSH, Mount Sinai Hospital **Responsibilities** In collaboration with Senior Director of Regulatory Affairs, and other system leadership, directs and facilitates… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Under direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the ... procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health care… more
- WMCHealth (Suffern, NY)
- …The Case Manager (RN) is responsible for implementing and supervising the day-to-day operations of the Case Management programs at Bon Secours Charity Health System. ... and outcome indicators developed by the medical staff, case management director and administration. + Provides orientation/mentoring to staff, completes scheduling,… more