- Elevance Health (New Hyde Park, NY)
- ** Medicare Medical Director - Part time** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible...specific position is $125,118 to $214,488. Prorated based on part -time hours. Locations: Illinois, Washington DC, New York In… more
- 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 problems of diverse...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 problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … 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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Evolent (Albany, NY)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Mount Sinai Health System (New York, NY)
- …environments * Seek to improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1) be responsible ... to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- Evolent (Albany, NY)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Elderwood (Lake Placid, NY)
- …regulations that govern the facility, and as may be directed by the Administrator, the Medical Director , and/or Director of Nursing, to ensure that the ... Salary $82,368 - $105,310 / year Overview Assistant Director of Nursing Pay Rate Range: $82,368 -...with experience! NEW, Gas Allowance Benefit for Full and Part -time positions! Elderwood of Uihlein at Lake Placid is… more
- Evolent (Albany, NY)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Elderwood (Williamsville, NY)
- …Williamsville is seeking a clinical leader for the important role of Assistant Director of Nursing (ADON - RN). The ideal candidate has excellent communication ... skills and an ability to foster teamwork. Assistant Director of Nursing (RN) Position Overview: + The ADON...and assures delivery of quality nursing services in a medical facility. + Develops, implements, communicates, and interprets nursing… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us...high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality ... rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
- Evolent (Albany, NY)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... in Cardiology** (with Cardiology training and clinical experience). + **Unrestricted medical license** in the state of residence and willingness to obtain… more
- Bassett Healthcare (Herkimer, NY)
- …the best quality of life possible. What you'll do The primary purpose of the Director of Social Services is to plan, organize, develop the Social Services Program in ... receive the highest degree of care while their social, medical and emotional needs and rights are met. The...to benefit from his/her stay with the facility. The Director of Social Services will be involved with the… more
- Bayer (Albany, NY)
- …diverse minds to make a real difference, there's only one choice.** **Associate Director - Field Reimbursement - Oncology - (Northeast USA)** **Associate Director ... HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Lead, Data Quality/Integrity understands end-to-end master data processes and flows and ... diverse scope and complexity ranging from moderate to substantial. The Associate Director , Data Quality/Integrity will lead and manage the HEDIS Supplemental Data… more
- Guthrie (Vestal, NY)
- …Performs annual performance reviews. 7. Functions under the direction of the SR. Director of post‐acute care services. 8. Assumes responsibility for the day to day ... functioning of Medicare certified home health agency. 9. Must have excellent...requirements. Other Duties: 1. As requested by the SR. Director of Post‐acute care. 2. Travel may be required… 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. **Qualifications** + 5 or more years...standards and billing regulations set by governmental agencies like Medicare and Medicaid. + May chair or participate in… more
- CenterLight Health System (NY)
- JOB PURPOSE: The Assistant Director , Revenue Cycle is responsible for the management and execution of enterprise-wide (CenterLight and its associated entities ... including C2Q Health Solutions, and Team Care Medical ) billing and revenue maximization activities, including analysis, reconciliation, and operational procedures to… more