- Humana (Albany, NY)
- …on quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation ... teaching conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , ...quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will… more
- Staffing Solutions Organization (Albany, NY)
- …**Division of Eligibility & Marketplace Integration (DEMI)** **Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries** **Telecommuting ... remote work may be given based on the candidate's home location and alignment with business needs. **Duties:** In...be successful in the position: + Work independently to review information submitted relative to Third Party Health… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at Administrative… more
- Humana (Albany, NY)
- … first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works ... clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate about contributing… more
- CVS Health (Albany, NY)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...care resources. This is a remote based (work from home ) role. Preferred candidates will have Internal Medicine or… more
- HCR Home Care (Plattsburgh, NY)
- …services and be able to problem-solve effectively. + Possess knowledge of the Medicare guidelines governing home health agencies. + Organized, ... shared responsibility for the overall provision and coordination of home health services provided to the HCR...as appropriate, to ensure proper coordination of care. + Review and approve all interim orders before they are… more
- CenterWell (Hauppauge, NY)
- …care patient services provided by clinical personnel. This role is a focused on both home health clinical quality assurance and home health clinical ... available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet… more
- Guthrie (NY)
- …a Difference One Home at a Time - Become a Clinical Liaison with Guthrie Home Health . Why Choose Guthrie? + Up to $25,000 Sign-On Bonus for Experienced RNs: ... & America's Best-In-State Employers 2024 Who We Are Guthrie Home Health NY brings care directly to...brings care directly to where patients need it most: home . As a 4-star CMS-rated Medicare -certified agency,… more
- HCR Home Care (Rochester, NY)
- …able to problem - solve effectively. + Possess es knowledge of the Medicare /Medicaid guidelines governing home health agencies. + Organized, detail-oriented ... shared responsibility for the overall provision and coordination of home health services provided to the HCR...or advising on patient care questions or concerns. + Review and approve all new interim orders before they… more
- HCR Home Care (Rochester, NY)
- …and be able to problem - solve effectively . + Possess knowledge of the Medicare guidelines governing home health agencies . + Organized, detail-oriented and ... shared responsibility for the overall provision and coordination of home health services provided to the HCR...appropriate , to ensure proper coordination of care. + Review and approve all interim orders before they are… more