- MVP Health Care (Rochester, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management ** to join #TeamMVP. If ... reviews, continued stay requests, and handling first-level appeals. + Collaborate with Utilization Management , Case Management , Quality Department and other… more
- Centene Corporation (New York, NY)
- …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering… more
- Humana (Albany, NY)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Stony Brook University (Stony Brook, NY)
- …including managing Case Management leadership and staff functions related to case management and utilization management activities. + Manage and mentor a ... Director of Case Management **Position Summary**...design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead… more
- 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 ... State and Federal Mandates and maintains current and working knowledge of Utilization Management Standards. + Clinical skills are excellent and evidence-based… more
- City of New York (New York, NY)
- …TASK FORCE: Management & Operations JOB TITLE: One (1) Assistant Director of Management and Operations CONTROL CODE: MOT-24-01 Summary: The Mayor's ... a more streamlined and responsive city government. Job Description: The Assistant Director of Management and Operations will provide leadership, strategic… more
- Centene Corporation (New York, NY)
- …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
- City of New York (New York, NY)
- …initiatives, and the implementation of integrated systems that govern real estate asset management and space utilization . The Director leads a profession ... Space and Design, and with wide latitude for independent judgment and initiative, the Director of the Division of Space Management (DSM) oversees all technical… more
- Evolent (Albany, NY)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
- Evolent (Albany, NY)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more