- Guthrie (Corning, NY)
- …Director and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) ... by managing care in a cost effective manner and communicating Coordinates medical management through ongoing interaction with the patient and family/caregivers,… more
- St. Mary's Healthcare (Amsterdam, NY)
- …coordinates, and oversees the operational functions of the Health Information Management Department to include, acute care, outpatient and ambulatory services and ... such information according to regulations. + Identifies, implements, and maintains medical coding quality and compliance within regulatory and accreditation standard… more
- Centene Corporation (New York, NY)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... Assist the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit.… more
- Humana (Albany, NY)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management . + Utilization management experience in a medical management.... + Utilization management experience in a medical management review organization, such as Medicare… more
- Whitsons Culinary Group (Islandia, NY)
- …+ Partner with TPAs and carriers to drive effective claim investigations, medical management , and settlement negotiations. + Oversee thorough incident ... Director of Safety and Risk Management Islandia, NY, USA Requisition Number 14783 Location...the primary liaison between Whitsons, our TPAs, carriers, and medical providers-while keeping employee wellbeing at the center of… more
- CVS Health (Albany, NY)
- …Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective ... care management solutions that promote high-quality healthcare for members. We...Use established guidelines to authorize services or escalate to Medical Directors as needed. + Navigate multiple computer systems… more
- University of Rochester (Rochester, NY)
- …Range or Pay Grade** 85376.00 **Description** The Laboratory Directorship with a MS in Medical Management position at the University of Rochester Medical ... management , medical directorship, and administration. Additional formal education in medical management will be accomplished with completion of a masters… more
- Molina Healthcare (NY)
- …provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical Management , Network, and other departments to enable critical decision ... projects related to medical cost reduction initiatives + Support Medical Management by assisting with Return on Investment (ROI) analyses for vendors to… more
- Molina Healthcare (Albany, NY)
- …provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical Management , Network, and other departments to enable critical decision ... to medical cost reduction initiatives and budgeting same + Support Medical Management by assisting with Return on Investment (ROI) analyses for vendors to… more
- Centene Corporation (New York, NY)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... with the provider community through the development and implementation of the medical management programs. + As needed, may represent the business unit before… more