- Molina Healthcare (Yonkers, NY)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Mount Sinai Health System is seeking a Medical Director of Physician Engagement and CDQI!** **Background:** Mount Sinai is one of the ... improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI,...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Assistant Director of Nursing 1 Psychiatric (NY HELPS), Kirby Forensic Psychiatric Center, P27567 Occupational ... Code 10035 Duties Description Kirby Forensic Psychiatric Center is recruiting an Assistant Director Nursing 1 Psychiatric to function as the Assistant Director … more
- Mount Sinai Health System (New York, NY)
- …Description** **The Mount Sinai Health System seeks an Obstetrics and Gynecology System Medical Director for its Ambulatory Services at Mount Sinai Hospital!** ... status for nursing care, and it is the only medical center in New York State to earn Disease-Specific...a Health Care Innovation Award from the Centers for Medicare and Medicaid Services to open the first geriatric… more
- Centene Corporation (New York, NY)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Molina Healthcare (Yonkers, NY)
- …to standardize policies and procedures. + Recruits, hires, trains, mentors, and develops medical director staff and team members as needed. + Ensures ... behavioral health and at least 3 years as a medical director in a managed care setting...management policies across health plans or navigating varied state Medicaid/ Medicare regulations. + Working knowledge of national, state, and… more
- New York State Civil Service (Brooklyn, NY)
- NY HELP Yes Agency Mental Health, Office of Title Director Nursing 3 Psychiatric (NY HELPS), Kingsboro Psychiatric Center, P26039 Occupational Category Health Care, ... a Joint Commission accredited Office of Mental Health (OMH) facility is recruiting a Director Nursing 3 (Psychiatric) to serve as the Chief Nursing Officer and is a… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Mount Sinai Health System is seeking a Senior Medical Director of Quality and Patient Engagement.** The Senior Medical Director ... payer classes, with deeper focus on patients who have Medicare and Commercial insuran This SMD will report to...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Ankura (New York, NY)
- …accreditations, operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment. The Senior Director ... to complex litigation, enforcement, and regulatory challenges. Role Overview The Senior Director will support the Healthcare Payer team within Ankura's Disputes &… more
- Molina Healthcare (Yonkers, NY)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the… more
- Centene Corporation (Queens, NY)
- …a fresh perspective on workplace flexibility. **Position Purpose:** The Senior Director , Healthcare Analytics leads analytic service delivery by aligning strategic ... of tools and capabilities and appropriate deployment of supporting analytic teams. The director serves in a leadership function spanning the needs of multiple health… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Director of Revenue Cycle Management Training & Education-Patient Financial Services- Corporate 42nd Street- Full-Time Days** The Director ... ensure regulatory compliance, and enhance the patient financial experience. The Director will collaborate closely with RCM leadership, clinical operations, IT, and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Associate Director Reimbursement-Financial Analysis Reimbursement-Corporate 42nd Street-Full-Time-Days** Ensures maximization of Reimbursement ... and maintains the monthly activity for the Blue Cross Medicare and Medicaid rate accounts/suspense accounts. + Analyzes the...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Bayer (Manhattan, NY)
- …minds to make a real difference, there's only one choice.** **Executive Director Access Business Partner** The Access Business Partner (ABP) is accountable for ... Marketing, Patient Services, and Global Market Access Strategy. As an Executive Director Access Business Partner, you will bring a sophisticated blend of strategic,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior Director for Population Health Quality and Patient Engagement drives the implementation and ongoing improvement initiatives that ... payer classes, with deeper focus on patients who have Medicare and Commercial insurance **Qualifications** + Graduate degree in...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Humana (New York, NY)
- …talent seeking enterprise visibility, strategic influence, and accelerated career growth. As the Director , Office of the CEO, you will work directly with the Chief ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Option Care Health (Manhattan, NY)
- …is maintained by providing direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also serve as the alternate ... administrator and or alternate director of nursing. **Job Description:** **Job Responsibilities** (listed... of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of… more
- Guidehouse (New York, NY)
- …remote **What You Will Do** **:** + Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialistprovides revenue cycle ... services through efficient review and timely resolution of assigned Medicare and third party payer accounts that are subject...Coding Initiatives (CCI) + Medically Unlikely Edits (MUE) + Medical Necessity edits + Other claim level edits as… more
- New York State Civil Service (Orangeburg, NY)
- …NY Zip Code 10962 Duties Description The successful applicant will be Director of the Emotional Brain Institute (EBI) which conducts neurodevelopmental animal ... EBI in relevant institutional meetings and will report to the Deputy Director . Minimum Qualifications Ph.D. and seven years of professional research experience in… more
- Mount Sinai Health System (New York, NY)
- …compliance of the organization and bridges the gap between clinical care and medical billing and reimbursement. This position will report to the Senior Director ... of clinical experience is required. Key skills include a strong understanding of medical terminology and patient care, expertise in medical coding systems and… more