- Excellus BlueCross BlueShield (Rochester, NY)
- …case reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on ARD cases, Quality ... evidence-based medicine skills are such that the individual provides review oversight for a broad array of clinical...mentor and resource throughout the workday in training medical director colleagues, as needed. + Conduct clinical … more
- Elevance Health (New York, NY)
- …staff including Medical Director Associates. May be responsible for an entire clinical program. **How will you make an impact:** + Supports clinicians to ensure ... responsible for an entire clinical program and/or independently performs clinical reviews. The Medical Director typically has program management… more
- University of Rochester (Rochester, NY)
- …Program Director : . Maintain Program ACGME Accreditation including routine review of and adherence to all program requirements, annual program evaluation, ... is accepting applications for the position of General Psychiatry Residency Program Director . This position is for a full-time Clinician-Educator at the rank of… more
- WMCHealth (Valhalla, NY)
- …Contact information of 3 references by email to:Nicole White,Advanced Clinical Recruiter at ###@wmchealth.org ORHumayun Islam, MD, PhD,Professor/Chairman/ Director ... Associate Program Director - Pathology Residency Program Company: WMC Advanced...maintain a residency program that is conducive to exceptional clinical learning and professional development. In addition to excellent… more
- Humana (Albany, NY)
- …experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received by members of ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- OLV Human Services (Lackawanna, NY)
- …program $$ Salary Range: $75,000 - $83,000.00 annually. Responsible to: Chief Officer of Clinical Services Job Summary: The Director of Nursing is an integral ... Join our Team: Director of Nursing Opportunity! Are you a compassionate,...Benefits: + Generous Paid Time Off (PTO) + Health, dental & vision insurance options + Paid employer sponsored… more
- Bassett Healthcare (Cooperstown, NY)
- …with reimbursement regulations and provides information to maximize reimbursement funding Clinical Oversight (if applicable) The Director has the following ... health and enjoy the best quality of life possible. What you'll do The Director of Dialysis & Rehabilitative Services and in partnership with the Chief, Nephrology,… more
- Humana (Albany, NY)
- …community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical ... consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director 's work includes computer based review of moderately complex to… more
- STG International (West Seneca, NY)
- …* Design and participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... STGi is currently seeking a Medical Director to provide services at our Community Based...effective operations of the CBOC and participate in the Clinical Quality Assurance Program. ESSENTIAL FUNCTIONS: * Provide vision… more
- WMCHealth (Valhalla, NY)
- …patient throughput, and standards of clinical practice, quality, education, and clinical operation. The Sr. Director recommends to the Vice President of ... Sr Director , Nursing - Peri-Op Services Company: WMC Advanced...Westchester Medical Center. Participates in evaluation of nursing and clinical practice through peer review . Assists in… more