• Director , Operational Excellence

    CenterWell (Albany, NY)
    …continuous learning, and performance excellence. **Cross-Functional Collaboration:** + Partner with clinical , analytics, and compliance teams to support coding ... part of our caring community and help us put health first** The Director , Operational Excellence will lead strategic initiatives to enhance the efficiency, accuracy,… more
    CenterWell (11/18/25)
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  • PCO Medical Director - UM - Full Time

    CenterWell (Albany, NY)
    …conflict resolution skills. An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes, and ... community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews...is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
    CenterWell (11/06/25)
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  • Medical Director - Medicaid N. Central

    Humana (Albany, NY)
    …Other duties include, but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes (including ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
    Humana (10/25/25)
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  • Medical Director - Nat'l UM IP (4x10 hr)

    Humana (Albany, NY)
    …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
    Humana (11/07/25)
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  • Medical Director - Claims Mgmt (Remote)

    Humana (Albany, NY)
    …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, ... Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by members in an… more
    Humana (11/01/25)
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  • Director of Revenue Intelligence -Patient…

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Director of Revenue Intelligence -Patient Financial Services- Corporate 42nd Street-Full-Time -Days (Hybrid)** The Director of Revenue ... and ensure accuracy, compliance, and efficiency throughout the revenue cycle. The Director will report to the Senior Director of Revenue Recognition… more
    Mount Sinai Health System (10/22/25)
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  • Director , Denial Resource Center

    Baylor Scott & White Health (Albany, NY)
    …Specialists, Payer Liaisons and Collectors focused on appealing hospital and professional clinical and coding denials, as well as Recovery Audit Contractors ... **Job Summary** The Director , Denial Resource Center is responsible for the...the strategic planning, evaluation, and operational oversight of the clinical denial management function for Baylor Scott and White… more
    Baylor Scott & White Health (10/04/25)
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  • Director of Revenue Engagement- Patient…

    Mount Sinai Health System (New York, NY)
    …registration, coding , and billing accuracy and performance. * Support clinical leaders and administrators by providing education on revenue cycle best practices ... **Job Description** ** Director of Revenue Engagement- Patient Financial Services-Corporate 42nd Street -Full-Time Days** The Director of Revenue Engagement acts… more
    Mount Sinai Health System (11/20/25)
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  • Medical Director , Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …+ Provides clinical expertise on ARD cases, Quality of Care cases, clinical editing, coding reviews and inquiries. + Makes accurate and consistent ... mentor and resource throughout the workday in training medical director colleagues, as needed. + Conduct clinical ...medical director colleagues, as needed. + Conduct clinical appeal case reviews and may require peer-to-peer discussions… more
    Excellus BlueCross BlueShield (09/30/25)
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  • Director of Authorization-Patient Financial…

    Mount Sinai Health System (New York, NY)
    …performance improvement plans as needed. . Collaborate with departments such as billing, coding , IT, clinical operations, and compliance to ensure a seamless ... **Job Description** ** Director of Authorization-Patient Financial Services Mount Sinai Health...processes. . Support organizational goals related to patient satisfaction, clinical efficiency, and access to care. . Utilize revenue… more
    Mount Sinai Health System (11/05/25)
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