- Excellus BlueCross BlueShield (Rochester, NY)
- …of the Medical Services area including, but not limited to, Medical and Pharmacy Utilization Management, quality management, member care management, and ... of Medicine or Doctor of Osteopathic Medicine. + The Physician is not the subject of any pending professional...I Qualifications) + Minimum 2-3 years of experience in medical management, utilization review and case management.… more
- Evolent (Albany, NY)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...Director you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Albany, NY)
- … Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . Participates ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...Oncology, you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Albany, NY)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of...Director you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Albany, NY)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a ... the culture. **What You'll Be Doing:** As a Field Medical Director, MSK Surgery you will be a specialty...cases. you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Albany, NY)
- … Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + Participates ... the culture. **What You'll Be Doing:** As a Field Medical Director, MSK Surgery you will be a key...Surgery you will be a key member of the utilization management team. We can offer you a meaningful… more
- Northwell Health (Staten Island, NY)
- …157934 Job Description Serves as liaison between the patient and facility/ physician . Ensures a continuum of quality patient care throughout hospitalization and ... delays and resolves issues with appropriate departments. + Identifies appropriate utilization of Social Work Services and makes referrals when appropriate. +… more
- Highmark Health (Albany, NY)
- …Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in ... standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical...and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician… more
- Fresenius Medical Center (Plainview, NY)
- …Charge Registered Nurse, utilizing standard nursing techniques to assist the physician in optimum patient outcomes following facility policies and procedures. ... thresholds in collaboration with facility management. + Maintains integrity of medical records and other organization administrative and operational records. +… more
- Elevance Health (New York, NY)
- … medical necessity of requests using clinical criteria. + Performs physician -level case review of musculoskeletal utilization requests. + Conducts ... **Clinical Operations Associate Medical Director** **Orthopedic Spine Surgery** **Carelon Medical...peer-to-peer consultation with ordering physicians, physician assistants and advanced practice nurses regarding established guidelines… more