• Medical Director - Southeast Region

    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 ... more
    Humana (02/07/25)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Albany, NY)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... more
    Humana (01/07/25)
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  • Lead Director , Provider Network…

    CVS Health (Albany, NY)
    …strategies. . Develops training sessions and communicates updates related to network management , utilization management , claims processing, and other ... more
    CVS Health (01/24/25)
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  • Director , Global Labeling Strategy Lead

    Takeda Pharmaceuticals (Albany, NY)
    …plasma-derived therapies for patients with immunologic, hematologic, and other complex diseases. The Director , Global Labeling Strategy Lead is a key role in the PDT ... more
    Takeda Pharmaceuticals (01/26/25)
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  • Associate Director , Global Labeling Lead…

    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 ... more
    Takeda Pharmaceuticals (01/15/25)
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  • Special Assistant (working title: Auditor) - VID

    New York State Civil Service (Albany, NY)
    …comprehensive site-visit audits as part of a robust risk assessment model for claims review and contract management .Essential functions of this position will ... more
    New York State Civil Service (02/01/25)
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  • Program Analyst 1 (Cannabis) - VID

    New York State Civil Service (Albany, NY)
    …quality control and quality assurance procedures for efficient and accurate management of applications, contracts, reimbursement claims , and progress reports. ... more
    New York State Civil Service (02/11/25)
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  • Billing Manager - Cardiology Associates…

    Trinity Health (Niskayuna, NY)
    …of the Billing Manager is to perform all duties associated with the management of the Billing department. Reporting to the Practice Administrator, the Manager of ... more
    Trinity Health (01/29/25)
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  • Principal Client Solution Architect - State…

    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 ... more
    Mathematica (01/04/25)
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  • Clinical Letter Writer - RN, LVN/LPN (Cardiology/…

    Evolent (Albany, NY)
    …to both members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . ... more
    Evolent (02/11/25)
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  • Nurse Manager

    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 ... more
    Northern Rivers Family Services (01/16/25)
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  • Senior Attorney/Assistant Attorney 1/2/3 (NY…

    New York State Civil Service (Schenectady, NY)
    …and any and all other motion or trial practice materials.* Advise the Medical Director 's Office as to provider authorizations, including whether there is ... more
    New York State Civil Service (02/11/25)
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  • Coordinator, UM Intake

    Evolent (Albany, NY)
    …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... more
    Evolent (02/11/25)
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  • Project Controls Specialist

    CS Energy (Albany, NY)
    …effectively utilizing project controls tools and track utilization for reporting to Director of Project Controls + Attend, participate, and contribute to cost ... more
    CS Energy (02/06/25)
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  • Assistant Attorney 1/ Assistant Attorney 2/…

    New York State Civil Service (Albany, NY)
    …researching applicable law, and case documents.* Communicate, discuss, and explain to Claims Department staff the basis for rejections of appeal requests;* Preparing ... more
    New York State Civil Service (01/09/25)
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