- 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 actively uses their medical background, experience, and judgement… more
- Humana (Albany, NY)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
- Humana (Albany, NY)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- ** Director , Medical Affairs Congress Strategy and Execution** The Director , Medical Affairs Congress Strategy and Execution, plays a pivotal role in ... and elevate our overall GMA objectives. **Position Overview** Reporting to the Senior Director of Medical Affairs Excellence & Operations, this role will… more
- Axis (New York, NY)
- …claims as well as the related coverage issues ensuring accurate and consistent claims management across impacted underwriting segments and lines of business + ... the selection process. AXIS is seeking a _Senior Claim Director , Specialty Complex_ _Claims_ to join our North America... skills + Experience practicing law as well as claims management (both directly managed and TPA… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- The Director , Global Medical Publications will support Otsuka in leading and developing an overall scientific communication strategy for publications and ... congresses, and will work closely with the Global Medical Affairs Teams, Clinical Teams, Global Value & Real-World Evidence Teams, and Publications Management … more
- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +...claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- … Management /Utilization Management (QM/UM) Plan, including having the BH Medical Director for Children's Services and participate on the BH committees ... of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has...claims and appeals and resolves grievances related to medical quality of care, as needed. + Ensures that… more
- Humana (Albany, NY)
- …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 problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Experience with the… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Complete understanding of… more
- Molina Healthcare (Syracuse, NY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Ankura (New York, NY)
- …Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice ... trade association guidance; and international compliance standards governing pharmaceutical and medical device operations. You will be joining a team of industry… more
- Humana (Albany, NY)
- …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 problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Director of Contract Compliance will oversee the contract compliance program, ensuring the organization's contracts, specifically related to ... contract compliance monitoring, risk identification, and issue resolution. The Director will collaborate with various internal departments, including legal, finance,… more
- EAC Network (Garden City, NY)
- …spending or funding. Timely submission of budget modifications per contract guidelines. + Claims Management + Oversee the voucher process for monthly/quarterly ... Director of Budgets & Contracts - Administration Job...a critical leadership role responsible for overseeing the financial management of over 100 programs funded by 60 different… more
- WTW (New York, NY)
- …+ Strong financial skills; prior experience in group disability underwriting or claims management strongly preferred + Proven experience creating project plans ... **Description** As an Absence, Disability Management and Life Associate Director , you will be at the forefront of managing projects for large, complex clients… more
- Evolent (Albany, NY)
- …health outcomes and a more connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected for this role will be part ... and its customers in the Performance Suite where Evolent does not pay claims + Establish ideal data transfer protocols during client onboarding and implementation,… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more