- Humana (Albany, NY)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of… more
- Calvary Hospital (Bronx, NY)
- …admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using standardized criteria to achieve ... Manager (RNCM) will be responsible for all aspects of case management for an assigned group of...utilization , risk and discharge planning to the Department Director . 17. Maintains working knowledge of regulatory and accrediting… more
- Humana (Albany, NY)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
- CenterWell (Albany, NY)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... prior experienceparticipatingin teams focusing on transitions of care, quality management ,utilizationmanagement, case management , discharge planning and/or… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …divisions + Provides clinical leadership for the implementation of new utilization / case /quality management initiatives Minimum Qualifications: Level I ... apply! Job Description: This position assists the Chief Medical Director to direct and coordinate the medical management...Level I + Provides medical leadership of all for utilization management , cost containment, and medical quality… more
- Evolent (Albany, NY)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- GMHC (New York, NY)
- …Proficiency in Microsoft Excel, including: + Data tracking and analysis for case management and program reporting. + Creating and managing spreadsheets ... Managing Director , Housing WFH Flexible * New York, NY...meetings, board updates, and staff training). Experience with electronic case management and data tracking systems, such… more
- Highmark Health (Albany, NY)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
- Mount Sinai Health System (New York, NY)
- …**ADVANCING OR THROUGHPUT WITH EVIDENCE-BASED QUALITY IMPROVEMENT:** + Monitor block time utilization and track departmental case volume. + Create, initiate and ... your career to new heights with this incredible opportunity! The Program Director is a credentialed Physician Assistant (PA), responsible for daily operations of… more
- Elevance Health (New York, NY)
- **Clinical Operations Medical Director ** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical management staff… more