- Humana (Albany, NY)
- **Become 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 work assignments involve moderately complex to complex issues...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes,… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Sumitomo Pharma (Albany, NY)
- …seeking a dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will ... for SMPA investigational and commercial products. The incumbent will provide medical safety support for safety signal management throughout product lifecycle… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... on ARD cases, Quality of Care cases, clinical editing, coding reviews and inquiries. + Makes accurate and consistent...and medical criteria. + Assists with training medical director colleagues and nursing staff ,… more
- Datavant (Albany, NY)
- …requirements, medical record standards, and regulatory guidance impacting concurrent coding or risk adjustment. + Product experience integrating into EHRs or ... experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Director , CDI Department: Clinical Documentation ImprovementLocation: Riedman CampusHours Per Week: 40Schedule: Monday - Friday, 8am - 4:30pmSUMMARY The ... Clinical Documentation Improvement Director provides a key role in advancing the long...to ensure accurate and timely clinical documentation in the medical record. RESPONSIBILITIES + Responsible for CDI operations ensuring… more
- CVS Health (New York, NY)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...predetermination reviews ad reviews of claim determinations, providing clinical, coding , and reimbursement expertise, using multiple computer based applications.… more
- Kyndryl (New York, NY)
- …justify a modernization financially. + Service Offering Development: A good Consulting Director will discover patterns of client problems and then collaborate across ... development process. + Delivery & Engagement Management: A Consulting Director 's job isn't done when the customer is ready...who believe they are eligible may apply for a medical or religious accommodation prior to the start of… more
- Datavant (Albany, NY)
- …professional, educational and life experiences to realize our bold vision for healthcare. The Director of Client Success will report to the VP of Client Success and ... and delivery perspective working closely with Client Success Managers. The Director of Client Success will communicate regularly with customer executives to… more
- Ankura (New York, NY)
- …investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding , and the computation ... and understand regulatory compliance guidelines and policies + Competent in medical coding + Proficient in review of revenue cycle data including EOBs,… more