- Molina Healthcare (Buffalo, NY)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… 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...early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies… more
- Ankura (New York, NY)
- …matters generally focused on Medicare and Commercial Risk Adjustment. The Senior Director will also support practice and firmwide business development ... solutions to complex litigation, enforcement, and regulatory challenges. Role Overview The Senior Director will support the Healthcare Payer team within Ankura's… more
- Centene Corporation (Queens, NY)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** The Senior Director , Healthcare Analytics leads analytic service delivery by ... 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
- CenterWell (Albany, NY)
- …and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy ... community and help us put health first** The National Medical Director for Home-Based Care Programs is...medical direction, clinical oversight, and advancement of CenterWell Senior Primary Care's (and Conviva Senior Primary… more
- Evolent (Albany, NY)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications -...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Albany, NY)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** +...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Mount Sinai Health System (New York, NY)
- …in primary care + Based on experience and demonstrated skill set, could consider Senior Medical Director level and associated compensation Compensation range ... improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI,...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- Evolent (Albany, NY)
- …MD provider is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Albany, NY)
- …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Humana (Albany, NY)
- …part of our caring community and help us put health first** The Director , Internal Audit develops, plans and evaluates internal audit programs for the organization's ... ensure compliance with the organization's policies, procedures and standards. The Director , Internal Audit requires an in-depth understanding of how organization… more
- Humana (Albany, NY)
- …satisfaction, engagement, and business value. We're looking for a customer-obsessed, results-driven Director of Product Design to lead the evolution of our digital ... focused on solving customer needs while enabling strategic and operational goals. As Director of Product Design, you'll lead a team of product designers while… more
- The New Jewish Home (Bronx, NY)
- …foster the application of continuous improvement principles and best practices among Medicare and Medicaid products, in collaboration with senior leadership and ... New Jewish Home is seeking for a full time Director of Patient Care to join our team. Job...training and supervision of nursing and field staff and medical compliance issues. Reports To: AVP, Home & Community… more
- Baylor Scott & White Health (Albany, NY)
- … senior leadership, hospital senior leadership, and senior medical staff including denials from all payers, Medicare /Medicaid audit activities and key ... **Job Summary** The Director , Denial Resource Center is responsible for the...improved utilization of appropriate patient care services. Collaborates with medical , clinical, HIM and other BSWH departments to ensure… more
- CVS Health (Albany, NY)
- …And we do it all with heart, each and every day. The Lead Director , National VBC Performance Planning & Insights will act as a strategic leader driving ... guide business decisions for national and local providers. The Director will also play a key role in supporting...efforts and adjusting strategies accordingly + Work closely with Medicare Quality team to ensure that reporting highlights areas… more
- Robert Half Finance & Accounting (New York, NY)
- …those most impacted by social determinants of health. Our client is seeking a Director of Finance to serve as a strategic and hands-on leader, reporting directly to ... and working closely with the Board of Directors and senior leadership team. This is a unique opportunity to...and ensure accurate billing, coding, and claims across Medicaid, Medicare , and private insurers . Guide long-term financial strategy… more
- CenterWell (Albany, NY)
- …, Informatics** will be responsible for supporting Patient Safety analytics on the Medicare population. The Associate Director is expected to perform and present ... of our caring community and help us put health first** The Associate Director , Informatics coordinates with other analytics, IT and business areas across the… more
- Insight Global (New York, NY)
- …and implement subsequent action plans. The role will report directly to the Senior Director of Operations. Responsibilities: * Develop and manage Payer ... Job Description About the Role: As Director of Payer Enrollment, you will play a crucial role in the leadership of our Payer Enrollment team. Our PE Team is core to… more
- WelbeHealth (Albany, NY)
- …senior care by providing an all-inclusive care option to our most vulnerable senior population. The Director , Federal Government Affairs will lead a bold ... regulatory affairs function with Congress and the Centers for Medicare and Medicaid Services (CMS) + Develop and implement...uniquely cared for. + 401k + employer match + Medical insurance coverage ( Medical , Dental, Vision) starting… more
- Molina Healthcare (Rochester, NY)
- …activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more