• Medical Director -Payment Integrity

    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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
    Humana (09/26/25)
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  • System Director Musculoskeletal…

    Catholic Health (Buffalo, NY)
    …high quality patient care. Together with the Medical Directors, the System Director develops a clinical support staffing plan, provider on-call schedules and ... Neuro-Critical Care unit(s). As the Dyad Partner to the Medical Director , Musculoskeletal Services, and the ...scope of services at each site, detail scope of practice for clinical providers an expansion of… more
    Catholic Health (08/13/25)
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  • Medical Director , Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …Functions as a mentor and resource throughout the workday in training medical director colleagues, as needed. + Conduct clinical appeal case reviews and may ... you, we encourage you to apply! Job Description: The Medical Director participates in the broad array...Minimum of seven (7) years of clinical practice experience after completion of all graduate medical more
    Excellus BlueCross BlueShield (09/30/25)
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  • Medical Director of Transplant…

    University of Rochester (Rochester, NY)
    …Medicine to ensure academic connections for Transplant Institute physicians. The Medical Director will help set the strategic and clinical direction of the ... Center, Department of Medicine (https://www.urmc.rochester.edu/medicine/about-medicine.aspx) is seeking a Medical Director of the Transplant Institute. (https://www.urmc.rochester.edu/transplant.aspx)… more
    University of Rochester (08/07/25)
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  • Administrative Medical Director

    Mount Sinai Health System (New York, NY)
    Director for Primary Care Outpatient Clinic on Columbus Avenue!** The Administrative Medical Director provides clinical and administrative leadership for ... success of the practice within the Mount Sinai Health System. The Medical Director serves as a key liaison between clinical staff, administration, and… more
    Mount Sinai Health System (09/22/25)
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  • Medical Director - OneHome

    Humana (Albany, NY)
    …Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the ... or >65 years of age) + Internal Medicine, Family Practice , Geriatrics, Physiatry, Emergency Medicine, Critical Care or hospital...national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case… more
    Humana (09/27/25)
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  • Field Medical Director

    Evolent (Albany, NY)
    …non- clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (07/30/25)
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  • National Medical Director

    CenterWell (Albany, NY)
    Medical Director for Home-Based Care Programs is a key clinical leadership position responsible for the medical direction, clinical oversight, ... polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy… more
    CenterWell (10/02/25)
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  • Manager, Medical Director

    Elevance Health (New Hyde Park, NY)
    …required by law. Alternate locations may be considered. The **Manager, Medical Director ** will serve as a clinical and strategic advisor to enterprise ... **Manager, Medical Director - Transformation Initiatives** Location:...program designs for alignment with quality, safety, and evidence-based clinical practice . + Guide affordability-focused programs with… more
    Elevance Health (10/04/25)
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  • Medical Director - Cardiology

    Elevance Health (New York, NY)
    ** Clinical Operations Medical Director **...of Internal Medicine or Surgery. + 3-5 years of clinical practice experience past fellowship training is ... Director review or policy interpretation. + Determine medical necessity of requests using applicable clinical ...Osteopathic Association (AOA). + Must possess an active unrestricted medical license to practice medicine or a… more
    Elevance Health (10/02/25)
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