- Humana (Albany, NY)
- …our caring community and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... episodic, home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- 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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Conviva (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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- Dartmouth Health (Bennington, VT)
- Overview Medical Director , Hospital Medicine Dartmouth Hitchcock Clinic is seeking a Medical Director to lead our Hospital Medicine service at ... average daily census is 45 and includes a 10-bed ICU. The Hospital Medicine Medical Director leads and oversees the medical care delivered by the hospitalist… more
- CVS Health (Albany, NY)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied … more
- 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
- Elevance Health (Latham, NY)
- **Clinical Ops Associate Medical Director ** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point ... analytics to improve the delivery of care. The **Clinical Ops Associate Medical Director ** is responsible for supporting the medical management staff… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation… 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 ... for behavioral health services across all lines of business. In addition, the Medical Director will be assigned to oversee the unique needs of CDPHP members 21… more
- Takeda Pharmaceuticals (Albany, NY)
- …knowledge. **Job Description** **About the role:** Join Takeda as a Senior Medical Director , Pharmacovigilance in Gastrointestinal and Inflammation (GI2). You ... for presentations to the Takeda Safety Board and similar forums. The Senior Medical Director will be a key player in the preparation and presentation of… more
- Evolent (Albany, NY)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , you will be a key member of the utilization management team. ... a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Elevance Health (Latham, NY)
- **Clinical Ops Associate Medical Director - Ortho** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health ... to improve the delivery of care. The **Clinical Ops Associate Medical Director - Ortho** is responsible for performing pre-authorizations and providing quality… more
- Pfizer (Albany, NY)
- **ROLE SUMMARY** The Internal Medicine Field Medical Director is responsible for providing therapeutic area/product expertise for the designated therapeutic area ... across a broad range of external medical stakeholders ("EMS") and initiatives in an assigned territory...US states). **ROLE RESPONSIBILITIES** + Plan and execute independent Medical strategies and engagements for appropriate assigned external … more
- YesCare Corp (Coxsackie, NY)
- …Veterans._ **Responsibilities** Below is a list of your responsibilities as a ** Medical Director at Coxsackie Correctional Facility located in Coxsackie NY** ... **Experience & Requirements** + Graduate of an accredited medical school. + Fully licensed to practice medicine...60-BED SKILLED NURSING SERVICES PROGRAM WITHIN THE COXSACKIE REGIONAL MEDICAL UNIT + Patients typically require closer monitoring and… more
- Merck (Albany, NY)
- **Job Description** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages in ... questions about Company products. The work of a Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support,… more
- Merck (Albany, NY)
- …This person _must_ reside in the territory. **Role Summary** + The Oncology Regional Medical Scientific Director - Head & Neck Cancers/Melanoma is a credentialed ... questions about company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support,… more
- Merck (Albany, NY)
- **Job Description** We are seeking a Growth and Improvement minded Regional Medical Scientific Director (AKA Medical Science Liaison / MSL) | in Inflammatory ... our Strategic Operating Priorities. **Summary, Focus and Purpose** The Regional Medical Scientific Director ( Medical Science Liaison) is a credentialed (ie,… more