- Molina Healthcare (Yonkers, NY)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… 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
- Molina Healthcare (Yonkers, 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
- Mount Sinai Health System (New York, NY)
- **Job Description** **Mount Sinai Health System is seeking a Medical Director of Physician Engagement and CDQI!** **Background:** Mount Sinai is one of the ... 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
- WelbeHealth (Brooklyn, NY)
- …our passion to treat the whole person rather than the symptoms. Reporting to the Chief Medical Officer, the Medical Director will be at the center of our ... IDT. The Medical Director oversees all medical ...enrolled or eligible for enrollment to provide services to Medicare and Medi-Cal participants). If you're ready to join… more
- Centene Corporation (New York, NY)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Mount Sinai Health System (New York, NY)
- …Description** **The Mount Sinai Health System seeks an Obstetrics and Gynecology System Medical Director for its Ambulatory Services at Mount Sinai Hospital!** ... status for nursing care, and it is the only medical center in New York State to earn Disease-Specific...a Health Care Innovation Award from the Centers for Medicare and Medicaid Services to open the first geriatric… more
- Molina Healthcare (Yonkers, NY)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Assistant Director of Nursing 1 Psychiatric (NY HELPS), New York State Psychiatic Institute (NYSPI), P27287 ... NY Zip Code 10032 Duties Description As an Assistant Director Nursing 1 Psychiatric, you will assist in the...OMH employees receive a generous benefits package including:* NYS medical , dental, & vision insurance* Access to tuition assistance… more
- New York State Civil Service (New York, NY)
- …facility, is recruiting a Clinical Director , Psychiatric Center, M-8. The Clinical Director serves as the facility's Chief Medical Officer and is responsible ... NY HELP No Agency Mental Health, Office of Title Clinical Director , Psychiatric Center, M-8, New York State Psychiatric Institute, P27140 Occupational Category… more
- Ankura (New York, NY)
- …accreditations, operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment. The Senior Director ... to complex litigation, enforcement, and regulatory challenges. Role Overview The Senior Director will support the Healthcare Payer team within Ankura's Disputes &… more
- Molina Healthcare (Yonkers, NY)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the… more
- New York State Civil Service (Bronx, NY)
- NY HELP Yes Agency Mental Health, Office of Title Educational Director 2 (NY HELPS), New York City Children's Center - Bronx Campus, P27199 Occupational Category ... cooperative projects for improvement of the program. Medicaid and Medicare : In order to be eligible for appointment and...Placement - Statewide (NY HELPS) program as an Education Director 2 if they have a permanent teaching certificate… more
- Centene Corporation (Queens, NY)
- …a fresh perspective on workplace flexibility. **Position Purpose:** The Senior Director , Healthcare Analytics leads analytic service delivery by aligning strategic ... 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
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Director of Enterprise Charge Description Master (CDM) -Patient Financial Services-Corporate 42nd Street-Full-Time -Days- Hybrid** The ... Director of the Enterprise Chargemaster (CDM) for the Mount...for the Charge Description Master, preferably in an academic medical center. + 5 plus years with Epic Experience… more
- Catholic Health Services (West Islip, NY)
- Overview The Director of Care Management is responsible for providing overall management of the Care Coordination department responsible for patient care ... of Care Coordination, Social Workers, and office administrative staff. In addition the director will oversee bed management including the Hub. Job Details The … 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 ... cycle management and ensure accurate billing, coding, and claims across Medicaid, Medicare , and private insurers . Guide long-term financial strategy to support… more
- The New Jewish Home (Bronx, NY)
- …The HAPI Division of The New Jewish Home is seeking for a full time Director of Patient Care to join our team. Job Summary: Oversees all clinical operations, ... improvement activities, training and supervision of nursing and field staff and medical compliance issues. Reports To: AVP, Home & Community Based Services and/or… more
- Molina Healthcare (Yonkers, NY)
- …and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and ... recontracting initiatives. Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads preparation… 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, ... practical application preferred. + Working knowledge of third-party payor guidelines/ medical necessity criteria such as InterQual(R) (ie, knowledge of admission… more