- CVS Health (Albany, NY)
- …ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied ... / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight...eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management) experience *Active and current state medical… more
- Humana (Albany, NY)
- …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Elevance Health (New York, NY)
- **Clinical Operations Associate Medical Director ** **Orthopedic Spine Surgery** **Carelon Medical Benefit Management** **Schedule: 10:30 AM-7 PM Central** ... an accommodation is granted as required by law._ The **Clinical Operations Associate Medical Director - Orthopedic Spine Surgery** is responsible for performing… more
- Elevance Health (Latham, NY)
- …to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation. **Minimum Requirements:** + ... **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management** **Post Acute Care Benefit Utilization Management** **Schedule:… more
- UHS (Johnson City, NY)
- Position OverviewUnited Health Services is seeking a Director of Nursing - Medical Surgical Services to lead strategic and daily operations across medical ... improvement, operational excellence, and high levels of patient and staff engagement. The Director ensures alignment with UHS standards and plays a central role in… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Access: Supports For Living (Middletown, NY)
- …IDD residential services and training certifications. + Partners with Quality Assurance on utilization review and utilization management for IDD Residential ... Assistant Director of IDD Residential Location: Middletown, NY, United...people with varying degrees of developmental disabilities and complex medical needs and co-occurring disorders. + The IDD Assistant… more
- Molina Healthcare (Yonkers, NY)
- …Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous ... Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review... medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in… more
- Evolent (Albany, NY)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... improving healthcare quality.** + **Computer proficiency** and ability to navigate electronic medical review platforms. + No current exclusions, sanctions, or… more
- CVS Health (New York, NY)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...responses to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides… more