- Mount Sinai Health System (New York, NY)
- …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...Supports the mission, vision, philosophy and goals of the Medical Center. 2. Case Management: The CM process will… more
- Bassett Healthcare (Delhi, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
- Travelers Insurance Company (Albany, NY)
- …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical ...Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board… more
- Bassett Healthcare (Cooperstown, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
- Elevance Health (New York, NY)
- …necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer ... **Clinical Operations Associate Medical Director** **Orthopedic Spine Surgery** **Carelon Medical Benefit Management** **Schedule: 10:30 AM-7 PM Central**… more
- Molina Healthcare (Yonkers, NY)
- …administrative incentives + Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** ... 3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management +… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and ... in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly...to social workers on patients in need of transfer, medical review and care planning + Coordinates,… more
- Evolent (Albany, NY)
- …improving healthcare quality.** + **Computer proficiency** and ability to navigate electronic medical review platforms. + No current exclusions, sanctions, or ... for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in **Performance… more
- STG International (West Seneca, NY)
- …safety. + Participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... of the Primary Care Physician is to provide covered professional outpatient primary medical services to enrolled patients of the Veterans Affairs Medical Center… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Lead Medical Director manages the physician review of health requests amongst a wide array ... of OneHome business. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s). The Lead Medical … more