- 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
- Aspen Dental (Albany, NY)
- …ensure proper handling of all claims . Under the general direction of the Director of Risk Management , the Claims Manager is responsible for mitigating, ... in three distinct categories: Dental care, urgent care, and medical aesthetics. Working in partnership with independent practice owners...a Claims Manager. **Job Summary:** The Risk Management Claims Manager will manage the administration… more
- Whitney Young Health Center (Albany, NY)
- …Apply Description GENERAL RESPONSIBILITIES: Responsible for reviewing medical claims prior to submission and ... complex or problem claims or insurance types as designated by the Director . Reviews payer coding policies and procedures to ensure that the department remains in… more
- Humana (Albany, NY)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… 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
- Merck (Albany, NY)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Western Digital (Albany, NY)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
- Humana (Albany, NY)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… 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
- Humana (Albany, NY)
- …functions strategy. + Establishes and oversees Medicaid segment trend mitigation strategy ( claims and revenue management ) + Researches industry trends and ... part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and… 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 ... Director Nursing Job Details Job Location Albany-Academy RTF/NorthStar...nurses located on the Parsons campus. + Oversee medication management including ordering, reconciliations, destruction and deliveries. + Ensure… more
- HomeSafe Alliance (Albany, NY)
- **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
- Baylor Scott & White Health (Albany, NY)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
- Humana (Albany, NY)
- …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… 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
- CVS Health (Albany, NY)
- …background in health care analysis methods and tools, clinical performance improvement ( Medical Loss Ratio/MLR, Medical Expenditure Management ), clinical ... health care more personal, convenient and affordable. **Position Summary** The Lead Director , Practice Transformation plays a key role by leading transformation of… 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
- CVS Health (Albany, NY)
- …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... services -Promotes communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers, and health… more
- Fujifilm (Albany, NY)
- …Sales Administrator for Latin America and the Caribbean will report to the Director of Sales for ID/Optical Devices/ EID. The primary responsibility of this position ... be to support sales for Latin America and Caribbean accounts currently under management by FNAC. Achieve the division sales plan, provide weekly and monthly detail… more
- Mathematica (Albany, NY)
- …or APCD claims data; EHR and/or HIE data; healthcare informatics; medical coding). * Ability to describe difficult technical problems and solutions to a ... data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and… more