- Kaleida Health (Buffalo, NY)
- …and tactics to successfully execute, support, implement, and monitor the DRG and Utilization Management Clinical Denial teams Work Plan and, assists in the ... / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and...Director Clinical and DRG Denials **Location** US:NY:Buffalo | Management | Full-Time **Req ID** null Equal Opportunity Employer… more
- Pfizer (Albany, NY)
- …IDNs and PBG organizations. The NVCD will also work closely with the iVCM team/Senior Director to review opportunities at the PBG member level and with the NAD ... for specific contracts and communicate learnings across the Vaccine Account Management /National Account Director organizations to increase effectiveness. This… more
- Catholic Health Services (West Islip, NY)
- …+ Ensures compliance with Hospital Conditions of Participation. + Implements care management programs, including utilization review , intake and discharge ... Overview The Director of Care Management is responsible...management leadership role is required. + Experience in utilization management , working with managed care organizations,… more
- Molina Healthcare (NY)
- …learn new programs. Preferred Qualifications * Experience with utilization /quality program management . * Managed care experience. * Peer review experience. * ... health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs… more
- Evolent (Albany, NY)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Radiology you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- MTA (Jamaica, NY)
- Director , Corporate Compliance Suburban Operations Job ID: 12715 Business Unit: MTA Headquarters Location: Jamaica, NY, United States Regular/Temporary: Regular ... Chief Compliance Off Date Posted: Aug 15, 2025 Description JOB TITLE: Director - Corporate Compliance Suburban Operations DEPT/DIV: MTA Corporate Compliance WORK… more
- Mount Sinai Health System (New York, NY)
- …the system on all matters related to medical staff governance, credentialing, peer review and performance management ; + In collaboration with the FPA, ... departments, business network development and faculty practice administration, budget management , strategic leadership, resource utilization , financial reporting,… more
- City of New York (New York, NY)
- …new vendors and growing the market. - Collaborating with MOCS & SBS to review agency reports tracking agency utilization of certified M/WBEs and general program ... You'll Solve: - Working closely with the M/WBE Deputy Director of AEO (Deputy Director ) to develop...data, coordinate outreach, and improve M/WBE contracting. - Project management tasks in support of program initiatives/special projects. -… more
- The Arc Erie County NY (Buffalo, NY)
- …Services and Community Supports arrange for needed revisions in budget with Director of Business Management + Coordinates activities of Vocational Employment ... serve. + Monitors implementation of service plans through regular records and utilization of review , case conferences, consultations, and supervision. + Facility… more
- Erie 2-Chautauqua-Cattaraugus BOCES (Buffalo, NY)
- …a comprehensive HR strategy, developed in partnership with the Executive Director ; that includes talent acquisition, retention, performance management , total ... Director of Human Resources Tapestry Charter School 65...workplace conflicts and concerns. + Ensure the creation and utilization of effective performance management , performance improvement… more