- 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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… 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...data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation… more
- CenterWell (Albany, NY)
- …a part of our caring community and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical leadership position ... polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy… 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 ... Sr. Director , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs, CNS Early Assets will be responsible… more
- Humana (Albany, NY)
- …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 scope and complexity ranging from moderate to substantial. The Corporate … 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. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… 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
- Evolent (Albany, NY)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Elevance Health (Latham, NY)
- **Manager, Medical Director - Transformation Initiatives** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... as required by law. Alternate locations may be considered. The **Manager, Medical Director ** will serve as a clinical and strategic advisor to enterprise… more
- CDPHP (Latham, NY)
- …who share these values and invites you to be a part of that experience. The Medical Director will assist the VP Member Health and Chief Medical Officer ... with regulatory, accreditation, corporate policies and strategic plan. The Medical Director will participate in medical advisory committees, provide… more
- MVP Health Care (Schenectady, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a ** Medical Director , Behavioral Health Children's Services** , to join #TeamMVP. ... two years must be in a clinical setting). Previous experience as a medical director in a managed care/health plan is desirable. + Individuals must understand… more
- Humana (Albany, NY)
- …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 scope and complexity ranging from moderate to substantial. The Corporate … more
- Evolent (Albany, NY)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in… more
- St. Mary's Healthcare (Amsterdam, NY)
- …Physician to lead our program at St. Mary's Hospital in Amsterdam, NY. The medical director is responsible for managing, directing and coordinating all aspects ... choice! Compensation: + $240.00 per hour (Days) + $250.00 per hour (Nights) + Medical Director Stipend: up to $15,000/month As an Emergency Medicine Medical … more
- Molina Healthcare (Albany, NY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- Evolent (Albany, NY)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Evolent (Albany, NY)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization ... a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more