- Humana (Albany, NY)
- …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in...on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming … more
- University of Rochester (Rochester, NY)
- …management , clinical services, pharmacy data analytics, and pharmacy procurement/inventory management . The Senior Director, Ambulatory Pharmacy Services in ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: The Senior Director, Ambulatory Pharmacy Services is responsible for the… more
- City of New York (New York, NY)
- …to fill one (1) Management Auditor II Auditor to function as a Senior Account Auditor who will: - Perform both Annual and Final closeout audits for CAMFR, ... - Review newly registered contracts to assure the accurate utilization when allocating allowable costs to its various funding...of Education and by the Council for Higher Education Accreditation (CHEA) in management , computer science, public… more
- Amazon (New York, NY)
- …Registration, Professional Engineer Registration, CEM and/or other building professional accreditation - Experience in building portfolio management and/or ... estate strategies and operations across our global fulfillment network. As a Senior Carbon Modelling Lead within the Global Realty Sustainability & Renewable Energy… more
- Evolent (Albany, NY)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Veterans Affairs, Veterans Health Administration (Buffalo, NY)
- …achieve goals for eligibility, referral and authorization, care coordination, and utilization management to ensure improved Veteran experience. Makes ... departments, internal and external customers, policies, and procedures. Participates in senior management business and clinical strategy development and… more
- Mohawk Valley Health System (Utica, NY)
- …+ 8 years of clinical experience. Previous or current experience working in Quality Management / Utilization Management field. + 5 years of management ... Affairs - Full Time - Days Department: QUALITY IMPROVEMENT Job Summary The Senior Director of Quality Management Systems and Regulatory Affairs is responsible… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work… more
- Evolent (Albany, NY)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Evolent (Albany, NY)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Albany, NY)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Stony Brook University (Stony Brook, NY)
- …(2) years of full-time experience with event planning and project management . Demonstrable proficiency with Microsoft Office and Google Applications. Experience ... to the Dean will provide high level oversight and management necessary to carry out the day-to-day administrative activities...skillfully with a very broad range of academic and senior staff from throughout the university and members of… more
- City of New York (New York, NY)
- …challenges and solutions on procurement matters; correspond with program and ACCO Senior staff for rapid solution. Participate in meetings concerning contract or ... order portfolio and provide accurate status of procurement actions. Promote increased utilization of City-Certified M/WBE vendors and assist in the achievement of… more
- US Tech Solutions (Tarrytown, NY)
- Reporting into Senior Director Strategic Sourcing , this position will support and lead the Health System's Value Analysis Program from Procurement / Supply Chain ... initiatives. - Lead material resource selection, standardization, price optimization and utilization initiatives while promoting and utilizing Value Analysis in the… more
- Evolent (Albany, NY)
- …members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately ... policies + Creates adverse determination notifications that meet all accreditation , State, and Federal criteria + Uses Plain Language...identifies potential cases for Care Management programs + Communicates appropriate information to other staff… more
- City of New York (New York, NY)
- …transition from shelter into appropriate permanent housing. DHS is responsible for management of over 200 facilities, which mainly are individual and family shelters ... - Serve as the primary liaison with Program Administrators and senior stakeholders, facilitating collaboration and effective communication across teams. - Oversee… more
- Trinity Health (Syracuse, NY)
- …Nurse Coordinator is a dynamic leadership role that contributes to the operational management of the unit to promote and support an environment of excellent patient ... healthcare standards and requirements established by various licensing, regulatory, and accreditation bodies. A Coordinator maintains a working knowledge of policies… more