• Medical Director Specialty…

    Molina Healthcare (Yonkers, NY)
    **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
    Molina Healthcare (01/21/25)
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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 (12/02/24)
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  • Director , Home Health Care

    BAYADA Home Health Care (North Bergen, NJ)
    **BAYADA** Home Health Care has an immediate opening for a ** Director ** to lead Medicare Certified services in Hudson and Essex Counties. This role requires an ... Prior Home Health or health care management experience required. Knowledge of Medicare Conditions of Participation strongly preferred. _This position is on-site with… more
    BAYADA Home Health Care (01/28/25)
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  • Director of Nursing

    Phoenix House (Long Island City, NY)
    …required regulatory and Healthcare Departments Policies and Procedures. + Works closely with Medical Director , CEO, Director of Residential Services, ... supply and equipment budgets in collaboration with the staff, medical director and CEO. + Develops measures...NYS RN License + NPI Number + Medicaid / Medicare Number (preferred) **REQUIRED EXPERIENCE** + Excellent verbal, written… more
    Phoenix House (11/28/24)
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  • Senior Director Contract Performance

    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 ... including Powerpoint and Excel Results orientation with working knowledge of medical economics analytics Understanding of CMS programs and concepts (eg, Star… more
    Mount Sinai Health System (12/06/24)
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  • Director Clinical Strategy and Initiatives,…

    Elara Caring (Bronx, NY)
    …providing the Right Care, at the Right Time, in the Right Place. ** Director Clinical Strategy and Initiatives, Home Care** At Elara Caring, we care where ... have countless ways to make a difference as a Director Clinical Strategy and Initiatives, Home Care Being a...+ Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer… more
    Elara Caring (12/17/24)
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  • Director Nursing

    Elara Caring (Paterson, NJ)
    …patient care, and that is a winning combination for our leadership team. Director Nursing with Elara Caring are operationally focused and results-driven, but some of ... improving clinical outcomes and implementing QAPI programs. As a Director Nursing with us, you shape the future of...+ Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer… more
    Elara Caring (12/03/24)
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  • Web Channel and SEO Director

    CVS Health (New York, NY)
    …and affordable. **Position Summary** The Web Channel Owner role for Aetna Medicare is a critical position in our Marketing organization, with accountability for ... shepherd the delivery of Digital Marketing's capabilities backlog for Aetna.com/ Medicare , AllinaHealthAetnaMedicare.com, the Shop, Buy, and Enroll tool, and more,… more
    CVS Health (12/13/24)
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  • Director , US Market Access Marketing…

    Pfizer (New York, NY)
    ** Director , US Market Access Marketing Oncology, Sasanlimab and Mevrometostat** **ROLE SUMMARY** The incumbent, within the US Market Access Marketing (USMA-M) team, ... development of the Customer/Brand engagement strategy for top accounts within Commercial, Medicare , and other channels as appropriate based on clinical and economic… more
    Pfizer (01/24/25)
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  • Director of Healthcare Payment & Financing…

    City of New York (New York, NY)
    …position on Medicaid redesign policy and innovation. Advise and assist OSHSSA Executive Director , Chief Medical Officer and other agency executives on healthcare ... and clinicians. The Bureau of Equitable Health Services seeks to hire a Director of Healthcare Payment & Financing Initiatives. DUTIES WILL INCLUDE BUT NOT BE… more
    City of New York (12/28/24)
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  • Senior Director , Scientific…

    Regeneron Pharmaceuticals (Sleepy Hollow, NY)
    The Senior Director , Scientific Marketing, will contribute to the financial success of Injection Brand and will report to the Executive Director , Marketing. This ... major congresses. + Works in close collaboration with Clinical, Med Affairs and Field Medical to ensure alignment with overall brand and medical strategic plans… more
    Regeneron Pharmaceuticals (11/06/24)
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  • Director , Risk Assessment & Accountability

    City of New York (New York, NY)
    …agency. The Department's main goal is to provide fire protection, emergency medical care, and other critical public safety services to residents and visitors ... Department, City of New York (FDNY), seeks a full-time Director , Risk Assessment & Accountability in the Office of...to augment the internal audit staff (eg, annual ambulance Medicare billing) - Liaison with external auditors. - Prepare… more
    City of New York (01/19/25)
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  • Director of Patient Services, Homecare RN…

    The New Jewish Home (Bronx, NY)
    …The HAPI Division of The New Jewish Home is seeking for a full time Director of Patient Care to join our team. Job Summary: Oversees all clinical operations, ... improvement activities, training and supervision of nursing and field staff and medical compliance issues. Reports To: AVP, Home & Community Based Services and/or… more
    The New Jewish Home (12/13/24)
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  • Director , SIU / Fraud Waste and Abuse…

    Molina Healthcare (Yonkers, NY)
    …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
    Molina Healthcare (01/04/25)
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  • Clinical Director , Select Health

    VNS Health (Manhattan, NY)
    …company holidays + Health insurance plan for you and your loved ones, Medical , Dental, Vision, Life Disability + Employer-matched retirement saving funds + Personal ... + Strong knowledge of Federal and state health care regulations related to Medicare , Medicaid, managed care, and long term care required CAREERS AT VNS Health… more
    VNS Health (01/17/25)
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  • Specialist, Grievance and Appeals

    VNS Health (Manhattan, NY)
    …of individual grievances and appeals. Consults with enrollees, providers and the Medical Director , as appropriate. + Provides input and recommendations for ... operations and customer service. + Reviews information available from Medicaid, Medicare , other payers, and/or professional medical organizations regarding… more
    VNS Health (01/23/25)
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  • Clinical Documentation Specialist

    Hackensack Meridian Health (Hackensack, NJ)
    …facilitates improvement in the overall quality, completeness and accuracy of medical record documentation for assigned hospital in the northern region of ... patient status. Facilitates accurate documentation for severity of illness and medical necessity. Interacts with physicians, case managers, and nursing staff and… more
    Hackensack Meridian Health (12/13/24)
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  • Manager, Grievance and Appeals, RN

    VNS Health (Manhattan, NY)
    …staff at all levels including but not limited to, Provider Relations, Claims, Medical Director , third party administrator, pharmacy benefit manager, to achieve ... and appeals across our Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health product lines. *...Health insurance plan for you and your loved ones, Medical , Dental, Vision, Life and Disability + Employer-matched retirement… more
    VNS Health (12/04/24)
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  • RN Supervisor

    Phoenix House (Long Island City, NY)
    …Shift** Morning **Job Category** Nurse **Description** **SUMMARY** Under the supervision of the Medical Director and/or Program Director , supervises the LPNs ... records for compliance; + Observes and records response to treatment/medication and notifies the Medical Director , the Director or Nursing, and the Program … more
    Phoenix House (12/09/24)
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  • Section Manager

    City of New York (New York, NY)
    …PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Medical Assistance Program (MAP) administers public health insurance programs, including ... health care services at little or no cost. The Medical Assistance Program is recruiting for one (1) Principal...will, under the general direction of the Excess Income/Surplus Director , with wide latitude for the exercise of independent… more
    City of New York (11/09/24)
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