- Molina Healthcare (Rochester, NY)
- …of strategic and operational project portfolios, with a focus on Network Cost of Care initiatives. Drive structure, organization, and decision-making across ... to C-level executives and manage key relationships with Corporate EPMO, IT, and Cost of Care stakeholders including COEs, Operating Domains, Med Econ, and… more
- Highland Hospital (Rochester, NY)
- …collaboration with the Director of Pharmacy Operations and the designated Residency Program Director , oversee the HH PGY1 Pharmacy Residency program and ... **17220BR** **Title:** Director of Pharmacy, Clinical Services **Department/ Cost ...outcomes; be actively involved in formulary management and therapeutic program proposals to contribute to the cost -effective… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …develops, directs and implements clinical and non-clinical activities that impact health care quality cost and outcomes. + Identifies and develops opportunities ... is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and medical cost , the financial forecasting and budgeting process, and program evaluation/ROI calculations for the health plan. The Director develops and ... Job Description: Summary The Director , Healthcare Economics is responsible for supervision of...support the organization's mission, as well as target corporate cost management goals, new initiatives and other complex measures… more
- University of Rochester (Rochester, NY)
- …and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: The Senior Director , Ambulatory Pharmacy Services is responsible for the oversight, ... pharmacy data analytics, and pharmacy procurement/inventory management. The Senior Director , Ambulatory Pharmacy Services in concert with the Chief Pharmacy… more
- Molina Healthcare (Rochester, NY)
- …care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost -efficiency, and continuity of care . ... adjustment, disease management, and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/Managed care experience **PR** **E**… more
- Molina Healthcare (Rochester, NY)
- …care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost -efficiency, and continuity of care . ... disease management, and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/Managed care experience **PREFERRED LICENSE,… more
- Molina Healthcare (Rochester, NY)
- …specific markets/regions. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * Provides behavioral ... ability to learn new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review… more
- Sedgwick (Rochester, NY)
- …Fortune Best Workplaces in Financial Services & Insurance Client Services Director | REMOTE | Casualty/Workers Compensation Experience required + ** Program ... and your career path. + Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs. **ARE YOU AN IDEAL… more
- Molina Healthcare (Rochester, NY)
- … Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... training of staff as needed. + Analyzes data and identifies medical cost savings and quality improvement opportunities. + Accounts for regulatory and accreditation… more
- Molina Healthcare (Rochester, NY)
- …most effective setting. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * Determines appropriateness ... care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost -efficiency, and continuity of care .… more
- Molina Healthcare (Rochester, NY)
- …strategic plans and objectives. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * Under the direction ... operations leadership, responsible for oversight of internal and external clinical program performance at Molina. * Monitors performance of assigned clinical… more
- Molina Healthcare (Rochester, NY)
- …Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads preparation and negotiations ... with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract/Re-contracting with large scale entities involving… more
- MVP Health Care (Rochester, NY)
- …to achieve optimum health and/or improved functional capability through the coordination of quality cost effective care . + The Case Manager will also monitor and ... At MVP Health Care , we're on a mission to create a...looking for a **Case Manager, Medicaid Long Term Support Program ** to join #TeamMVP. If you have a passion… more
- Person Centered Services (Rochester, NY)
- …volunteering or personal wellness! + Professional development opportunities including mentorship program options and ongoing coaching Bilingual Spanish Care ... caseload, while tailoring services to individual needs. + Completes program enrollment and eligibility document. + Completes and secures...Other related duties, as may be assigned by the Care Coordinator Supervisor or Director of … more
- Episcopal SeniorLife Communities (Rochester, NY)
- …responsibilities on the unit. + Maintain contact and ensure compliance with the skin integrity program . + Ensure care plans and care cards are updated as ... Director of Nursing guidance. + Identify areas where cost control is needed. Discuss observations with director...as indicated. Work with staff in projects to reduce cost while maintaining the high quality of care… more
- Rochester Regional Health (Rochester, NY)
- …only occasionally and all other sedentary criteria are met. For disease specific care programs refer to the program specific requirements of the department ... Ensures compliance with benefit laws and regulations. With guidance from the Director and Vice President, the Benefits Manager develops, recommends and implements… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential Accountabilities: Level I + Handles physical ... to identify and implement member-centric interventions to ensure optimal and cost -effective health outcomes. Collaborates with interdisciplinary care team to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in conjunction with Medical Policy leadership and applicable Medical Director (s). Essential Accountabilities: + Develops and maintains corporate medical policies ... for data analysis of assigned medical policies assessing the utilization and cost effectiveness for their assigned policy. This data along with clinical and… more
- University of Rochester (Rochester, NY)
- …is responsible for providing input to annual budgets for the SIM Program . Performs routine and non-routine duties requiring highly advanced administrative skills and ... minimum direction. Works collaboratively with the Supervisor, Medical Office, Asst. Director , Clinical Administration, Nurse Manager, and Medical Director to… more