- 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 (Albany, NY)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... more
- CVS Health (Albany, NY)
- …strategies. . Develops training sessions and communicates updates related to network management , utilization management , claims processing, and other ... more
- 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 (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
- 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 (Albany, NY)
- …quality control and quality assurance procedures for efficient and accurate management of applications, contracts, reimbursement claims , and progress reports. ... more
- 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
- 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
- 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
- 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
- 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
- Evolent (Albany, NY)
- …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... more
- 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
- 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