• Director of Care Coordination (RN)

    Catholic Health Services (West Islip, NY)
    …not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals, Managed Care and Revenue Cycle and Patient Access departments to ... Overview The Director of Care Management is responsible...role is required. Experience in utilization management, working with managed care organizations, and discharge planning is… more
    Catholic Health Services (07/18/25)
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  • Behavioral Health Medical Director

    Humana (Albany, NY)
    …services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed ... help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care ...medical management review organization, such as Medicare Advantage and managed Medicaid + Experience with national guidelines such as… more
    Humana (08/09/25)
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  • Complex Care Program Director

    City of New York (New York, NY)
    …State agencies (eg, SDOH, SOMH, OASAS, OPWDD), community health, mental health, and managed care organizations around child mental health services at DHS; write ... for one City Research Scientist IVA to function as the Complex Care Program Director who will. Report directly to the Department of Social Services Chief… more
    City of New York (07/13/25)
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  • Director of Care Management - Mount…

    Mount Sinai Health System (Long Island City, NY)
    …to the hospital. Must be able to navigate through a wide variety of managed care contractual issues. Must have knowledge of and familiarity with Interqual ... **Job Description** The Director will direct and manage departmental activities involved...and APNs Pediatric Oncology depts.) Non-Bargaining Unit, 140 - Care Management - MSQ, Mount Sinai Queens **Responsibilities** 1.Reviews… more
    Mount Sinai Health System (07/24/25)
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  • Director , HARP Care Management

    Healthfirst (NY)
    …(LCSW), or Licensed Master Social Worker (LMSW) + 7 years of behavioral health experience in managed care and/or a clinical setting with at least 2 years of that ... experience being in managed care + Progressive leadership experience in medical and behavioral health care management including work experience in a senior… more
    Healthfirst (07/25/25)
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  • Medical Director - NorthEast Region

    Humana (Albany, NY)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care more
    Humana (07/25/25)
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  • Family Care Coordination Assistant…

    City of New York (New York, NY)
    …State agencies (eg, SDOH, SOMH, OASAS, OPWDD), community health, mental health, and managed care organizations around child mental health services at DHS. ... for two (2) City Research Scientist-III to function as a Family Care Coordination Assistant Director who will: - Direct program development and research in the… more
    City of New York (08/13/25)
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  • Senior Director , Patient Financial…

    Mount Sinai Health System (New York, NY)
    …and EHR systems. + Organizes routine meetings with health system business leaders and managed care to review payer issues and denials. + Builds effective, ... **Job Description** **Senior Director , Patient Financial Services (Backend Revenue Cycle) Corporate...with key stakeholders across departments (eg, DTP, Human Resources, Managed Care , Finance, and clinical departments) +… more
    Mount Sinai Health System (08/12/25)
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  • Medical Director -Pharmacy Appeals

    Humana (Albany, NY)
    …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...responsibilities as determined necessary to support optimal value based care in accordance with Medicare and Humana policy. The… more
    Humana (08/22/25)
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  • Casa Director

    City of New York (New York, NY)
    …with activities of daily living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the Assisted Living Program, ... Commissioner, Medical Assistance Program and the Deputy Commissioner, Home Care Services Program and/or the Executive Director ,...Home Care Services Program and/or the Executive Director , Home Care Services Field Operations that… more
    City of New York (08/13/25)
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