- Molina Healthcare (Albany, NY)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (Yonkers, 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
- Centene Corporation (Queens, NY)
- …is critical in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special Needs Plans ... incentive programs, attribution logic, and provider engagement strategies. + Represent Medicare VBP in governance discussions and escalate operational issues… more
- Humana (Albany, NY)
- …efforts that enhance both provider and patient experience. **Governance & Delegation Oversight ** The Clinical Director will participate in governance committees ... part of our caring community and help us put health first** The Clinical Director is a key member of the regional clinical leadership team responsible for executing… more
- Albany Medical Center (Albany, NY)
- …leadership. The Director oversees and leads the day to day operational , programmatic, financial, and employee related activities, as applicable, under the System ... Day (United States of America) Salary Range: $133,724.95 - $213,959.93 The Director is responsible for overseeing as well as implementing, developing, maintaining,… more
- New York State Civil Service (NY)
- …HELP No Agency People With Developmental Disabilities, Office for Title Deputy Director DDSO 2, Bridge Deputy Director Occupational Category Other Professional ... leader who can execute strategic decisions to serve as the Bridge Deputy Director of the Developmental Disabilities State Operations Office in Region 6 (DDSOO 6… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …implementation of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has overall accountability for BH services ... interdisciplinary complex care management rounds. + Provision of clinical oversight and leadership to Utilization Management/Case Management (UM/CM) staff working… more
- CenterWell (Albany, NY)
- …and communicate remediation plan to IPA Dyad partners. + Partners with market operational leaders to identify operational issues that impact clinician and coder ... staff workload and redistribute resources as needed to meet market operational demands. + Monitor coding processes, identify inefficiency, and develop… more
- The New Jewish Home (Bronx, NY)
- …The HAPI Division of The New Jewish Home is seeking for a full time Director of Patient Care to join our team. Job Summary: Oversees all clinical operations, ... of quality metrics to support performance improvement initiatives and quality/compliance oversight . o Serves as quality subject matter expert with other stakeholders… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Billing Director -Patient Financial Services- Corporate (ON SITE) Full-Time -Days** Responsible for direction and management responsibility over ... the business and operational activities of a department or medical care unit....training materials and train employees when necessary. + Provides oversight to management staff to ensure compliance with established… more
- CenterWell (Albany, NY)
- …Director , the Senior Strategy Advancement Professional will bring a combination of operational support, analyst skills, and strategy oversight to the role. ... (ACO) business. This role will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid… more
- Fallon Health (Buffalo, NY)
- …PACE Program Director to oversee and manage PACE program level operational and regulatory functions in support of the program's quality, strategic and financial ... to local contracted partners to provide support/guidance on various operational topics. $95,000 **Responsibilities** **Primary Job Responsibilities:** **Data management,… more
- Molina Healthcare (Albany, NY)
- …in collaboration with the Manager or Director . * Keeps Manager or Director apprised of operational issues, including staffing resources, program and system ... drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient… more
- New York State Civil Service (Bronx, NY)
- …Duties Description The incumbent will be responsible for administrative duties for the Director , Assistant Director , and facility. Duties include, but are not ... purchase of goods and services. Maintain facilities financial records. Provide oversight of confidential client information. * Manage central files, printing,… more
- New York State Civil Service (Brooklyn, NY)
- …Code 11239 Duties Description Clinical Supervision of the nursing staff:* Provides oversight , guidance and training to ensure tasks and standards are met.* ... concert with nurse educator.* Conducts regular rounds to agency sites based on operational need (at direction of DON) to ensure coordination and delivery of nursing… more
- Molina Healthcare (Buffalo, NY)
- …strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core ... contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight . Tighter knit proximity ongoing after contract. * In conjunction… more