- Elevance Health (New Hyde Park, NY)
- ** Medicare Medical Director ** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- Molina Healthcare (New York, NY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- RVO Health (New York, NY)
- **AT A GLANCE** RVO Health is looking for an Associate Director , Medicare Product Manager to improve how seniors find and select their Medicare plans. 88% of ... seniors report that they find enrolling in a Medicare plan to be confusing and overwhelming. Our mission...different subjects at your fingertips + Health Insurance Coverage ( medical , dental, and vision) + Life Insurance + Short… more
- Centene Corporation (Queens, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... will lead and support the expansion and optimization of Medicare -focused VBP arrangements across New York. This role is...position will be responsible for working with the VBP Director , other VBP Managers, and Analysts, as well as… more
- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… 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
- Molina Healthcare (New York, NY)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... State Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- Northwell Health (Westbury, NY)
- **Req Number** 158136 Job Description The Director , Corporate Finance (RIO) promotes the financial viability of Northwell Health by effectively managing the ... organization's revenue capture operations. The Director works in close partnership with many aspects of...master. + Oversees and assists in the resolution of Medicare / Medicaid edits generated on hospital outpatient and… more
- Molina Healthcare (Yonkers, NY)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
- New York State Civil Service (New York, NY)
- …the Chief Medical Officer/Clinical DirectorUnder the general direction of the Director of NYSPI and in close collaboration with other facility executive staff, ... NY HELP No Agency Mental Health, Office of Title Deputy Director , Psychiatric Research Institute, M-8, New York State Psychiatric Institute, P26164 Occupational… more
- Bayer (Stamford, CT)
- …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
- Catholic Health Services (Smithtown, NY)
- …of Siena Hospital. You are at the heart of health. Job Details The Director of Care Management and Nursing operations is responsible for providing overall management ... Care Coordination, Social Workers, and office administrative staff. In addition the director will oversee bed management including the Hub and the nursing… 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
- Lumeris (New York, NY)
- …its people and empowers you to make an impact. **Position:** Senior Director , Partner Operations **Position Summary:** Provides executive leadership and oversight of ... in Health Administration, or similar degree + Experience in managed care and/or Medicare Advantage **Working Conditions** + While performing the duties of this job,… more
- Catholic Health Services (Melville, NY)
- …Qualifications: 1. Minimum Education/Training Required: Graduate of an accredited medical school. Completion of specialty residency (ie, Internal Medicine, Emergency ... their practical application preferred. Working knowledge of third-party payor guidelines/ medical necessity criteria such as InterQual(R) (ie, knowledge of admission… more
- Mount Sinai Health System (New York, NY)
- …Description** The Manager, Government Model Operations will lead operational execution for Medicare value-based care programs, beginning with the Medicare Shared ... governance activities for the Mount Sinai Health Partner IPA and Medicare Accountable Care Organization (ACO), and lead internal coordination across cross-functional… more
- New York State Civil Service (Bronx, NY)
- …Bronx State NY Zip Code 10461 Duties Description NYCCC is recruiting a Director of Clinical Risk Management Department to oversee their Risk Management Department ... will supervise the Clinical Risk Managers (CRM) assigned to the department. The Director will have on-call and recall responsibilities along with evening work hours.… more
- Phoenix House (Long Island City, NY)
- …Shift** Morning **Job Category** Nurse **Description** **SUMMARY** Under the supervision of the Medical Director and/or Program Director , supervises the LPNs ... records for compliance; + Observes and records response to treatment/medication and notifies the Medical DIrector , the Director or Nursing, and the Program … more
- City of New York (New York, NY)
- …health outcomes for all New Yorkers. CHECW sits under the Agency's Chief Medical Officer. The Bureau of Equitable Health Systems (BEHS) is the healthcare systems ... health outcomes for all New Yorkers. CHECW sits under the Agency's Chief Medical Officer. The Bureau of Equitable Health Systems (BEHS) is the healthcare systems… more
- CenterWell (Hauppauge, NY)
- …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more