- Elevance Health (Latham, NY)
- The ** Medical Management Clinician Associate ** is responsible for ensuring appropriate, consistent administration of plan benefits by reviewing clinical ... information and assessing medical necessity under relevant guidelines and/or medical policies. **Location:** **Virtual -** This role enables associates to work… more
- Highmark Health (Albany, NY)
- …and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of ... or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment and retrospective… more
- Parexel (Albany, NY)
- …Clinical Research Associate (Sr. CRA) is responsible for the site management , site monitoring and close-out of assigned clinical trials investigator sites to ... and the Sponsor's standards. The Sr. CRA is accountable for site management and monitoring, managing investigator site relationships to ensure effective delivery of… more
- Elevance Health (Latham, NY)
- ** Medical Management Nurse** **Hours: 8am-5pm EST** **Location** : This role enables associates to work virtually full-time, with the exception of required ... an accommodation is granted as required by law. The ** Medical Management Nurse** is responsible for review...process improvement initiatives. + May help to train lower-level clinician staff. **Minimum Requirements:** + Requires a minimum of… more
- CVS Health (Albany, NY)
- …departments. + Strong communication skills. + Strong organizational and time management skills. **Education** + Master's-level clinician and/or RN, licensed ... to coordinate, document, and communicate all aspects of the utilization/benefit management program. + Conduct clinical reviews for adult inpatient behavioral health… more
- Albany Medical Center (Albany, NY)
- …Developmental Behavioral Pediatrician Functions of our team include: + Diagnostic assessments and medical management of patients up to 21 years of age with ... Medicine is seeking an experienced Pediatric Intensivist at the Associate or Full Professor level to join our team....region. We are looking for a compassionate and skilled clinician with a strong interest in medical … more
- Humana (Albany, NY)
- …IT integration efforts to Humana's corporate development team and integration management office (IMO) on all growth opportunities (M&As, Divestitures, Joint Ventures ... clinical applications (eg, Athena), analytics, and cybersecurity while protecting clinician productivity and patient experience. **Key Responsibilities** **Due Diligence… more