- 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
- 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
- Outreach Development Corporation (Brentwood, NY)
- …The Assistant Director /Clinical Coordinator is responsible for assisting the Site Director with the management of the administrative and clinical components ... Calendar and other reports or systems indicated by the Director + Ensures that residential case records...congruency with the Outreach House Program Description + Facilitates case conferences, level of care assessments and utilization… 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
- Molina Healthcare (Syracuse, NY)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case ...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… more
- Arnot Health (Elmira, NY)
- …$10,000 Sign on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for ... denied by payer. Under the direction of the System Director of Care Coordination coordinates data with other Arnot...inclusive of all duties that may be assigned. MEETINGS: Case management staff meetings. Case … 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
- Molina Healthcare (NY)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
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