- Highmark Health (Albany, NY)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Elevance Health (Middletown, NY)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management ** **Post Acute Care Benefit Utilization Management ** ... for the people we serve._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the... Director ** is responsible for supporting the medical management staff ensuring timely and consistent… more
- Humana (Albany, NY)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Centene Corporation (New York, NY)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. This ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Elevance Health (New York, NY)
- …The ** Medical Director , Cardiology** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to ... **Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This role enables associates to work virtually full-time, with the exception of required… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: Medical Director -Associate Professor/Professor in the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology. Clinical ... experience. Clinical expertise including radical and robotic surgery, chemotherapy and medical management of gynecologic cancers. Experience in directing funded… more
- Evolent (Albany, NY)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… 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 ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- City of New York (New York, NY)
- …INCLUDE BUT NOT BE LIMITED TO: - Act as principal advisor to the Medical Director on the development, execution, and monitoring of high-profile priority projects ... and programs. Support the Medical Director in...Coordinate with Administration and Operations on onboarding activities for Medical Unit and Administrative staff, including the management… more
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