- Eisai, Inc (New York, NY)
- …customers based on the marketplace within which they operate. Work closely with Medicaid Director and other cross-functional teams to review and analyze ... At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides...for assigned regional payer accounts including Commercial, Medicare and Medicaid (State Medicaid agencies, managed Medicaid… more
- Humana (Albany, NY)
- **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 ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Albany, NY)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- New York State Civil Service (New York, NY)
- …No Agency Attorney General, Office of the Title Legal Nurse: Investigate Medicaid Fraud/Patient Abuse (6400) Occupational Category Legal Salary Grade NS Bargaining ... Office of the New York State Attorney General's (OAG) Medicaid Fraud Control Unit (MFCU) is seeking experienced Registered...(MFCU) is seeking experienced Registered Nurses to serve as Medical Analysts in its New York City office. … more
- NTT DATA North America (Albany, NY)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Senior Medicaid Solution Architect to join our team in Albany, New York ... Operations & Systems The Senior Solution Architect will report to the Technology Director for the Division of Operations and Systems and have responsibility for… more
- MVP Health Care (Rochester, NY)
- …care. + The Case Manager will also monitor and review cases with the Medical Director to ensure appropriate outcomes. + Service Authorization & Review: Conduct ... team at ###@mvphealthcare.com . **Job Details** **Job Family** ** Medical Management/Clinical** **Pay Type** **Salary** **Hiring Min Rate** **56,200 USD**… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- Humana (Albany, NY)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture** + **Knowledge and experience with national guidelines… more
- Humana (Albany, NY)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture + Knowledge and experience with national guidelines… more
- Humana (Albany, NY)
- …and related tasks; works under minimal supervision; and assists in supporting the medical director team and leaders in meeting enterprise-wide business ... community and help us put health first** The Corporate Medical Director (CMD) relies on medical...+ Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about… more
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