- Molina Healthcare (NY)
- …HEDIS, Medicaid, Medicare and Pharmacy benefit management , Group/IPA practice , capitation, HMO regulations, managed healthcare systems, quality improvement, ... including: + 2 years previous experience as a Medical Director in a clinical practice . + Current..., and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE,… more
- New York State Civil Service (Schenectady, NY)
- …up to the Director of Nursing 3. - Will act in an administrative / management capacity in the absence of the Director of Nurisng 3. Telecommuting to be ... NY HELP Yes Agency People With Developmental Disabilities, Office for Title Assistant Director of Nursing ( Director Nursing 1 DD) Occupational Category Health… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …2-3 years of experience in medical management , utilization review and case management . + Knowledge of managed care products and strategies. + Demonstrated ... we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of...including, but not limited to, Medical and Pharmacy Utilization Management , quality management , member care management… more
- Highmark Health (Albany, NY)
- …**Required** + 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice ) **Preferred** + 1 year in Medical Management in a Health ... as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest...Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical… more
- Kaleida Health (Buffalo, NY)
- …**Position** Director Clinical and DRG Denials **Location** US:NY:Buffalo | Management | Full-Time **Req ID** null Equal Opportunity Employer Kaleida Health is ... ** Director Clinical and DRG Denials** **Location:** Larkin Bldg...execute, support, implement, and monitor the DRG and Utilization Management Clinical Denial teams Work Plan and, assists in… more
- Catholic Health Services (West Islip, NY)
- Overview The Director of Care Management is responsible for providing overall management of the Care Coordination department responsible for patient care ... of Care Coordination, Social Workers, and office administrative staff. In addition the director will oversee bed management including the Hub. Job Details The… more
- MVP Health Care (Rochester, NY)
- …two years must be in a clinical setting). Previous experience as a medical director in a managed care/health plan is desirable. + Individuals must understand ... thinking and continuous improvement. To achieve this, we're looking for a **Medical Director , Behavioral Health Children's Services** , to join #TeamMVP. If you have… more
- Turner & Townsend (New York, NY)
- …success. Our capabilities include programme, project, cost, asset and commercial management , controls and performance, procurement and supply chain, net zero and ... together to provide clients with the premier programme, project and cost management offering in markets around the world. **Job Description** Excellent opportunity… more
- Molina Healthcare (Syracuse, NY)
- …in clinical practice * 3 years' experience in Utilization/Quality Program Management * 2+ years HMO/ Managed Care experience * Experience demonstrating strong ... HEDIS, Medicaid, Medicare and Pharmacy benefit management , Group/IPA practice , capitation, HMO regulations, managed healthcare systems, quality improvement,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Director of Revenue Engagement- Patient Financial Services-Corporate 42nd Street -Full-Time Days** The Director of Revenue Engagement acts ... Ambulatory Care Sites, and Physician-Based Practices (PBP) and Revenue Cycle Management (RCM) operations. This role is responsible for reviewing, assessing, and… more