- Humana (Albany, NY)
- …members. The Director , Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training ... responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with...medical director team to assist and facilitate new hires and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Mount Sinai Health System is seeking a Medical Director of Physician Engagement and CDQI!** **Background:** Mount Sinai is one of the ... improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement...for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of… more
- Catholic Health Services (Melville, NY)
- …department, and presents to Physician Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. ... hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the… more
- STG International (West Seneca, NY)
- …the Primary Care Physician is to provide covered professional outpatient primary medical services to enrolled patients of the Veterans Affairs Medical Center ... full and unrestricted medical license in the state in which the physician practices. (State specific license in which the CBOC is located required). +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …departmental policy and procedure, identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate ... position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and...regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and… more
- Centene Corporation (New York, NY)
- …state, corporate, and accreditation requirements. + Assists the Chief Medical Director in the functioning of the physician committees including committee ... + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the...and credentialing functions for the business unit. + Provides medical leadership of all for utilization management,… 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 ... but not limited to, Medical and Pharmacy Utilization Management, quality management, member care management, and ...and medical criteria. + Assists with training medical director colleagues and nursing staff ,… more
- Molina Healthcare (Syracuse, NY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... + 3+ years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- Humana (Albany, NY)
- …and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Evolent (Albany, NY)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be... management while working in conjunction with the Senior Medical Director . May assist the Senior … more