• Medical Director , Clinical Review and Care…

    MVP Health Care (Tarrytown, NY)
    …relevant regulatory/accreditation requirements (eg, CMS, NCQA, DOH) + Knowledge of quality improvement including HEDIS , STAR, CAHPS measures is preferred. + ... for everyone - which requires innovative thinking and continuous improvement . To achieve this, we're looking for a **Medical.... To achieve this, we're looking for a **Medical Director , Clinical Review and Care Integrity** to join #TeamMVP.… more
    MVP Health Care (08/04/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Rochester, NY)
    … activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, ... necessity. + Participates in and maintains the integrity of the appeals process , both internally and externally. Responsible for the investigation of adverse… more
    Molina Healthcare (06/29/25)
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  • Medical Director , Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area ... medical policies, guidelines and medical criteria. + Assists with training medical director colleagues and nursing staff , including leadership of teaching grand… more
    Excellus BlueCross BlueShield (07/01/25)
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  • Medical Director , Post-Acute Care…

    MVP Health Care (Tarrytown, NY)
    …evaluate and research medical literature is essential + Knowledge of quality improvement including HEDIS , STAR, CAHPS measures is preferred. + Knowledge ... for everyone - which requires innovative thinking and continuous improvement . To achieve this, we're looking for a **Medical.... To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management** to join #TeamMVP. If… more
    MVP Health Care (08/04/25)
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  • Population Health Manager

    Apicha Community Health Center (New York, NY)
    …supporting improvement of patient health outcomes + Support implementation process and data optimization efforts to ensure data is accurate and reliable ... a multidisciplinary staff to meet Population Health and quality improvement goals through projects aligned with the mission of...and statements of work under the guidance of the Director of Population Health Management + Monitor project progress… more
    Apicha Community Health Center (05/22/25)
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