- Humana (Albany, NY)
- **Become a part of our caring community and help us 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims and preservice appeals. The Corporate Medical Director works on...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for analysis of Medicaid and Medicare financial reports, trend, and opportunities. Includes evaluation of and ... recommendations relating to business opportunities, Medicare bids, investments, financial regulations, and similar financial projects or programs. Duties include… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... Description: Summary: Conducts case management program activities in accordance with departmental, corporate , NYS Department of Health (DOH), Centers for Medicaid & … more
- Humana (Albany, NY)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Albany, NY)
- …the Medicare Line of Business. **Additional Information** Typically reports to Lead or Corporate Medical Director , depending on size of region or line of ... caring community and help us put health first** The Medical Director actively uses their medical...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Albany, NY)
- …adapt and the courage to innovate **Additional Information** Typically reports to a Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Centene Corporation (New York, NY)
- …regulatory, state, corporate , and accreditation requirements. + Assists the Chief Medical Director in the functioning of the physician committees including ... providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals and families...+ Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the… more
- Centene Corporation (Queens, NY)
- …a fresh perspective on workplace flexibility. **Position Purpose:** The Senior Director , Healthcare Analytics leads analytic service delivery by aligning strategic ... of tools and capabilities and appropriate deployment of supporting analytic teams. The director serves in a leadership function spanning the needs of multiple health… more
- Heritage Ministries (Gerry, NY)
- …development of all assigned employees. Seeks direction from the Human Resource Director or Corporate Human Resource Coordinator regarding personnel matters. ... is in growth mode and are currently seeking a Director of Finance to join our team! The ...the CFO with financial and statistical information on all corporate activities. . Maintains financial control procedures and records… more
- Humana (Albany, NY)
- …caring community and help us put health first** The Associate Director ; Software Renewals establishes and implements hardware and software acquisition, protection, ... procedures that are aligned with IT standards and strategy. The Associate Director ; Software Renewals requires a solid understanding of how organization capabilities… more
- Molina Healthcare (Rochester, NY)
- …the state health plan. Works with direct management, senior leadership/management, Corporate , and staff to develop and implement standardized provider contracts and ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Clinical Revenue Auditor-CDM Patient Financial Services- Corporate -Full-Time-Days-Option to work remote or hybrid.** The Clinical Revenue ... organization and bridges the gap between clinical care and medical billing and reimbursement. This position will report to...and reimbursement. This position will report to the Senior Director CDM of the Mount Sinai Health System This… more
- Catholic Health Services (Melville, NY)
- …(UR), discharge planning (DP), LOC and clinical documentation. + Works with Corporate Compliance to interpret new regulatory and compliance requirements and develops ... Qualifications: 1. Minimum Education/Training Required: + Graduate of an accredited medical school. + Completion of specialty residency (ie, Internal Medicine,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and… more
- Grifols Shared Services North America, Inc (Albany, NY)
- …business customers. The SSR will liaise with Marketing, Managed Markets, Operations, CL&D, Medical Affairs and Telesales to achieve the goals of the company. The SSR ... and commercial insights and monthly business planning discussions with Regional Sales Director *Better use of existing tools like Excel, Word *Use of Technology… more
- Callen-Lorde Community Health Center (New York, NY)
- MANAGER OF BILLING (CPC) Job Details Job Location Corporate /Administrative Office - Chelsea - New York, NY Secondary Job Location(s) Callen-Lorde Community Health ... health issues. About the Role TheManager of Billingworks directly with the Director of Billing Operations to oversee all billing, reconciliation, and collections for… more
- HCR Home Care (Rochester, NY)
- …documentation of such conferences via the Case Conference Coordination Note in the medical record . + With the assistance of the Clinical Field Staff Supervisor ... patient . + In collaboration with the HR Department and Regional Director , participate in recruitment of qualified personnel and implementation of effective… more
- Loretto Management Corporation (Syracuse, NY)
- …analysis to budget and all account reconciliations. + Adheres to all corporate policies and procedures, and third party agency regulations. + Applies knowledge ... of various Medicare , Medicaid, and other third party billing rules. +...personnel, including performance management, scheduling, and orientation. With the Director and Human Resources guidance, makes or approves recommendations… more