• Medical Director - National

    Humana (Albany, NY)
    …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical ... caring community and help us put health first** The Medical Director relies on medical ...Prefer Medicaid experience + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (03/11/25)
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  • Medicare Benefits Standards & Guidance Lead…

    CVS Health (Albany, NY)
    … Medicaid Services) requires regulatory changes during the plan year. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** ensures accountability for ... Individual general enrollment, Special Needs Plans (SNP) and Employer Groups. The ** Medicare ** **Benefits Standards & Guidance Lead Director ** acts as the… more
    CVS Health (03/14/25)
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  • Medical Billing Specialist…

    Elderwood (Buffalo, NY)
    …us support our commitment to providing exceptional care to our residents. Medical Billing Specialist ( Medicare /Managed Care) Position Overview: + Responsible for ... package, Life Insurance, Medical , Dental, and Vision insurance Responsibilities Medical Billing Specialist ( Medicare /Managed Care): + Review remittances for… more
    Elderwood (03/19/25)
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  • Medical Director - Care Plus…

    Humana (Albany, NY)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (03/18/25)
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  • Physician Medical Director - LTSS

    Humana (Albany, NY)
    …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Director will learn National LTSS State ... community and help us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical more
    Humana (01/25/25)
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  • Medical Director - Medicaid N.…

    Humana (Albany, NY)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (03/11/25)
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  • Field Medical Director , Cardiology

    Evolent (Albany, NY)
    …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (02/14/25)
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  • Field Medical Director

    Evolent (Albany, NY)
    …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (01/30/25)
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  • Medical Director (New York)

    Molina Healthcare (New York, NY)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (03/04/25)
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  • Medical Director Physician…

    Mount Sinai Health System (New York, NY)
    …environments * Seek to improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1) be responsible ... to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
    Mount Sinai Health System (03/04/25)
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  • Assistant Director of Nursing 1 Psychiatric…

    New York State Civil Service (Rochester, NY)
    NY HELP Yes Agency Mental Health, Office of Title Assistant Director of Nursing 1 Psychiatric (NY HELPS), Rochester Psychiatric Center, P25700 Occupational Category ... Zip Code 14620 Duties Description Rochester Psychiatric Center is recruiting an Assistant Director Nursing 1 Psychiatric to function as the Assistant Director of… more
    New York State Civil Service (03/13/25)
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  • Behavioral Health Medical Director

    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...compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
    Humana (02/15/25)
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  • Field Medical Director , Genetic…

    Evolent (Albany, NY)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Genetic Testing you will be a key member of the utilization ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
    Evolent (02/18/25)
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  • ADON - Assistant Director of Nursing

    Elderwood (Lancaster, NY)
    …- $110,000 / Yearly Overview Apply HERE for Full Time RN - Assistant Director of Nursing Opportunity with Elderwood at Lancaster! At Elderwood, our Mission is People ... a clinical leader for the important role of Assistant Director of Nursing (ADON - RN). The ideal candidate...and assures delivery of quality nursing services in a medical facility. + Develops, implements, communicates, and interprets nursing… more
    Elderwood (02/07/25)
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  • Medical Director , Children's…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …and implementation of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has overall accountability for ... of the Quality Management/Utilization Management (QM/UM) Plan, including having the BH Medical Director for Children's Services and participate on the BH… more
    Excellus BlueCross BlueShield (03/07/25)
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  • Senior Director - Emergency Management…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Senior Director of Emergency Management Planning and Development is an expert in current federal, state, local, and non-governmental ... possesses a general knowledge of healthcare operations. The Senior Director is a key member of the Mount Sinai...US Dept of Health and Human Services Center for Medicare and Medicaid Services (CMS). + Interacts with emergency… more
    Mount Sinai Health System (03/15/25)
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  • Associate Medical Director

    Evolent (Albany, NY)
    …for the mission. Stay for the culture. **What You'll Be Doing:** **Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** Are you ... to drive meaningful change beyond the bedside? Evolent Health is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in… more
    Evolent (03/04/25)
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  • Regional Director of Operations - NY3

    CVS Health (Jamaica, NY)
    …Regional Vice President with close collaboration with regional leaders such as the Senior Medical Director , the Population Health Director , and the Regional ... and every day. **Company:** Oak Street Health **Title:** Regional Director of Operations **Location:** By Region **Role Description:** The...experience in a supervisory role in a clinical or medical setting, with at least 2 years of multi-site… more
    CVS Health (03/18/25)
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  • Assistant Director Infection Prevention…

    Stony Brook University (Stony Brook, NY)
    …with the Director of Healthcare Infection Prevention and Control and the Medical Director . **Duties of an Assistant Director of Healthcare Infection ... Assistant Director Infection Prevention and Control **Position Summary** The...patients EMR) prior to ICP's reporting such to the National Healthcare Safety Network (NHSN), discussing with the unit… more
    Stony Brook University (02/06/25)
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  • Associate Director - Value-Based Specialty…

    Humana (Albany, NY)
    …our caring community and help us put health first** The Associate Director - Value-based Specialty and Vendor Support role builds templates, standard documentation, ... case studies, and disseminates best in class knowledge. The Associate Director requires a solid understanding of how organization capabilities interrelate across… more
    Humana (03/04/25)
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