- Molina Healthcare (Buffalo, NY)
- …health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs ... - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Stony Brook University (Stony Brook, NY)
- …the Director will advance institutional advising priorities through effective management of advising technologies, systems, and outreach. The Director will ... Director of Advising Systems & Technology **We are...intersection of technology and student success. **Duties:** **Advising Systems Management ** + Serve as system manager for CRM. +… more
- Monte Nido (White Plains, NY)
- …for people to realize their healthy selves. **Eating Disorder Clinical Director ** **Monte Nido Eating Disorder Center of Westchester** **White Plains, NY** ... life challenges. We are seeking a **Eating Disorder Clinical Director ** to join the **Monte Nido** team. The **Mental...experience elsewhere. + Working knowledge of admissions and intake, Utilization Review, and 3rd party or insurance payers. +… more
- Stony Brook University (Stony Brook, NY)
- …Flow Cytometry & Lyme Laboratory sections). Under the direction of TH Assoc Technical Director , she /he will be responsible for oversight of the operations to ensure ... ensure efficient workflow under the direction of the SL-5 Associate Technical Director , Immunology Laboratory. This includes ensuring test results are timely and all… more
- NewYork-Presbyterian (New York, NY)
- …the Partner of the Year awards for Sustained Excellence in Energy Management - the energy program's highest honor. NewYork-Presbyterian was the only hospital ... receive this award amongst 15,000 organizations. Transform your career as a facilities management leader. Take the reins and lead the daily operations of a renowned… more
- Healthfirst (NY)
- …maintain and improve department performance** + **Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement** + ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
- Humana (Albany, NY)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Albany, NY)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … 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 in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- CenterWell (Albany, NY)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
- Samaritan Daytop Village (Queens, NY)
- …and agency administration. The Program Director will be responsible for census/ utilization management and quality assurance. What You Will Do + Supervise ... Community is Everything Help LEAD Yours! LCSW Program Director -OASAS Facility Staten Island Social Workers, psychotherapists and mental health professionals can work… more
- Molina Healthcare (Albany, NY)
- …years as a medical director in managed care setting supporting utilization management /quality management initiatives, or equivalent combination of ... of prior authorization, inpatient concurrent review, discharge planning, care management and interdisciplinary care team (ICT) activities. * Recruits, hires,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Guthrie (Cortland, NY)
- Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert ... Packer Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures… more
- Centene Corporation (New York, NY)
- …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Mount Sinai Health System (New York, NY)
- …: + Active RN license in the state of employment required + Certification in Case Management (CCM, ACM) or Utilization Management preferred. + 7+ years of ... **Job Description** ** Director Pre Appeals Management -HSO Appeals ...experience in clinical acute clinical, utilization management , appeals management or… more
- Publicis Groupe (New York, NY)
- …Beam, Kellogg's, Nintendo, Tillamook and UnitedHealthcare among others. **Overview** The Director of Resource Management is responsible for strategic allocation ... with executive leadership, including Talent, Finance, and Department Heads, the Director shapes and executes a comprehensive resource management strategy… more
- Evolent (Albany, NY)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall...selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with… more
- City of New York (New York, NY)
- …TASK FORCE: Management & Operations JOB TITLE: One (1) Assistant Director of Management and Operations CONTROL CODE: MOT-24-01 Summary: The Mayor's ... a more streamlined and responsive city government. Job Description: The Assistant Director of Management and Operations will provide leadership, strategic… more
