- Humana (Albany, NY)
- …clinical group practice management + Utilization management experience in a medical management review organization, such as Medicare Advantage and managed ... management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present… more
- Elevance Health (Latham, NY)
- …**Carelon Medical Benefits Management** **Post Acute Care Benefit Utilization Management** **Schedule: 10:00-7:00 Central Time** **** **Virtual:** This role ... board certified specialty. + Makes physician to physician calls to gather medical appropriate information...decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director … more
- Project Renewal, Inc. (New York, NY)
- …in the development and implementation of quality assurance management and utilization review + Participates in interdisciplinary meetings with shelter ... Title: Primary Care Physician - Part Time Program: Healthcare Department ,...Brooklyn Hours: Monday, Thursday, and Friday 9-5 Reports to: Medical Director, Primary Care Salary: $111,000 to $120,000 depending… more
- Rochester Regional Health (Rochester, NY)
- …soon as possible after admission-within the first 12 to 24 hours. Applies utilization review criteria to assess and document appropriateness of admission, ... is obtained and documented in the patient chart. Forward patient chart to physician for review when problems are identified. Intercedes with appropriate… 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
- Rochester Regional Health (Rochester, NY)
- …stay of patients across the continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on medical ... for the hospital. + Documents level of care and medical necessity in the Care Management Data base to...the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization ,… more
- Albany Medical Center (Albany, NY)
- …our HIV Medicine Clinic team of dedicated healthcare providers! The Albany Medical College Division of HIV Medicine (DHIVM) offers comprehensive HIV services ... including primary medical care, medical case management, medication adherence,...focused, team-based department. Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision… more
- Albany Medical Center (Albany, NY)
- …be part of the Bernard & Millie Duker Children's Hospital at Albany Medical Center. We offer a friendly team-oriented work environment centered on efficient, ... No weekends/holidays Job Description Summary Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse… more
- Albany Medical Center (Albany, NY)
- …be part of the Bernard & Millie Duker Children's Hospital at Albany Medical Center team. We offer a friendly team-oriented work environment centered on efficient, ... within the Pediatric Endocrine division. Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse… more
- Albany Medical Center (Albany, NY)
- …Oncology - Melodies Center Albany, NY Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager ... treating provider + Obtains and documents a patient's history ( Medical , Surgical and Social) and focused physical assessment, related...to patients in clinic, under the direction of a physician or APP + Participates in in-office procedure, as… more