- Molina Healthcare (Syracuse, NY)
- **Job Description: Director , Operational Oversight ( Medicare )** **Job Summary** Responsible for planning, developing and directing the implementation of ... operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve.… more
- Molina Healthcare (Syracuse, NY)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (Rochester, NY)
- …**Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function ... as Medicare subject matter expert and point of contact for...drive compliance and performance objectives as well as provide oversight , including service level agreements. + Works with staff… more
- Molina Healthcare (Buffalo, NY)
- …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
- CenterWell (Albany, NY)
- …improvement. + Work collaboratively with the Strategy Advancement and Operations Director to align clinical and operational priorities. **Quality Improvement ... and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical...skills; ability to collaborate effectively with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare … more
- Ankura (New York, NY)
- …accreditations, operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment. The Senior Director ... class and globally recognized independent experts who tailor financial, operational , and compliance solutions to complex litigation, enforcement, and regulatory… more
- Molina Healthcare (Buffalo, NY)
- …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
- Stony Brook University (Commack, NY)
- Director of Managed Care Contracting **Position Summary** Stony Brook Medicine is seeking an experienced and strategic Director of Managed Care Contracting to ... Managed Care. This leadership role is responsible for the oversight , negotiation, and management of all Managed Care contracts...financial goals. Under the direct supervision of the Assistant Director of Managed Care, the Director will… more
- Truecare Homecare Agency (Brooklyn, NY)
- …Director of Clinical Operations will be responsible for the day-to-day and strategic oversight of all key operational functions of the agency. The ideal ... New York, Westchester, Long Island, and Colorado. Our focus is on compliance, compassion, and operational excellence as we serve diverse communities. The Senior … more
- Baylor Scott & White Health (Albany, NY)
- …, Denial Resource Center is responsible for the strategic planning, evaluation, and operational oversight of the clinical denial management function for Baylor ... Scott and White Health (BSWH). The Director , Denial Resource Center will lead a highly skilled...function for BSWH. + Recommends and implements strategic and operational plans and priorities for clinical denial management aligned… more