- 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- City of New York (New York, NY)
- Job Description The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs, for the City of New York. Applying ... the Reimbursement Division, is responsible for determining consumer eligibility for Medicaid reimbursements of out-of-pocket medical expenditures and for the… more
- Humana (Albany, NY)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTATIVE DIRECTOR OF SOCIAL SERVICE CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR ... CHANGE. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to...Services Program (HCSP) is recruiting for one (1) Administrative Director of Social Services NM II, to function as… 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 ... Medicare, Medicaid , NCQA and other regulatory requirements. + Reviews quality...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- City of New York (New York, NY)
- Job Description YOU MUST BE PERMANENT IN THE ADMINISTRATIVE DIRECTOR OF SOCIAL SERVICE CIVIL SERVICE TITLE, PERMANENT IN A COMPARIBLE TITLE CHANGEL ELIGIBLE FOR ... oversight for Home Attendant and Housekeeping services for active cases. The Executive Director of Field Operations plans and manages the activities of the following… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...+ Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: Medical Director -Associate Professor/Professor in the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology. Clinical ... Responsibilities: Maintain an active clinical practice in Gynecologic Oncology including medical and surgical management and chemotherapy. Assume leadership role in… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …and implementation of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has overall accountability for ... BH services for all Medicaid Managed Care enrollees under age 21 years. Essential...Quality Management/Utilization Management (QM/UM) Plan, including having the BH Medical Director for Children's Services and participate… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Must be passionate… more