- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …the asset lifecycle. This role reports directly into the Executive Director , Medical Excellence and Operations. **Job Description** **Key Responsibilities ... The Director , Strategic Planning & Operations is a pivotal...multi-year strategic roadmaps tailored to each therapeutic area **Budget Management ** + Oversee budgets for global medical … more
- CVS Health (Albany, NY)
- …cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a medical director to be part of a...licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another Health… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- The Director , Congress and Medical Education Strategy & Execution is responsible for developing and leading the global medical strategy and tactical ... outcomes through deep scientific understanding and collaborative partnerships. The Director partners closely with global and regional cross-functional stakeholders -… more
- Mount Sinai Health System (New York, NY)
- …patient outcomes while controlling costs. The Director collaborates closely with medical staff, vendors, case management , and payers to secure payment and ... **Job Description** ** Director Pre Appeals Management -HSO Appeals ...**Preferred Qualifications (Industry-Specific)** : + Healthcare: Experience with utilization management for medical services, procedures, or medications… more
- Centene Corporation (New York, NY)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- WMCHealth (Poughkeepsie, NY)
- …event, an aberrant practice pattern, a potential lawsuit, etc.) and alerts the department director , medical staff leadership, and claims manager. + Conducts ... an aberrant practice pattern, a potential lawsuit, etc.) and alerts the department director , administration, and the claims manager. Initiates a more thorough… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. This ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Mount Sinai Health System (New York, NY)
- …and strategic business needs (eg, market sizing), and healthcare topics (eg, claims analysis) with guidance from Quality Director ? Effective communicator ... strong reputation for quality of care (18th ranked academic medical center) and research/education (22nd ranked medical ...transition to a business model focused on population health management - our goal is to keep entire communities… more
- Molina Healthcare (Albany, NY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- United Therapeutics (Albany, NY)
- …compliance risks and responds effectively and efficiently. The Senior Corporate Compliance Director , Risk Management reports to the Chief Compliance Officer and ... is responsible for leading the Department's risk management activities. The Senior Corporate Compliance Director will develop the auditing and monitoring… more