- Molina Healthcare (Albany, NY)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- CVS Health (Albany, NY)
- …markets. + Enables operating model for partnership with local General Managers, Director of Operations, CFOs, Medical Directors, Network Managers, Medical ... it all with heart, each and every day. **Position Summary** The Medicare Performance Management Lead Business Consultant will facilitate and support implementation… more
- Centene Corporation (Latham, NY)
- …perspective on workplace flexibility. **This role will be responsibel for all non- Medicare Strategy. The ideal candidate will have a strong Medicaid background.** ... Present results and analysis of improvement efforts and ongoing performance measures to senior management + Performs other duties as assigned + Complies with all… more
- Albany Medical Center (Albany, NY)
- …and utilization management, quality, credentialing, and other related departments. The Director builds external relationships with payers' senior network ... States of America) Salary Range: $133,724.95 - $213,959.93 The Director is responsible for overseeing as well as implementing,...contracting, as well as the provision and reimbursement of medical services including, but not limited, to Medicare… more
- Evolent (Albany, NY)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications -...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Albany, NY)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** +...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Albany, NY)
- …MD provider is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Albany, NY)
- …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Albany, NY)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... with cross-functional teams, including **clinical reviewers, product, management, and senior leadership,** to improve decision-making and care outcomes. + Assist… more
- CenterWell (Albany, NY)
- …MSSP, and future models. Under general direction and supervision from the ACO Director , the Senior Strategy Advancement Professional will bring a combination of ... an in-depth understanding of the healthcare industry, including value-based care, Medicare , population health, Accountable Care Organizations (ACOs), medical … more
- CenterWell (Albany, NY)
- …Leaders to identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying business partner ... of management experience + 8 or more years of Medical Coding, IPA, or similar experience + Medical...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record… more
- Humana (Albany, NY)
- …Executive Communications + Work with AVP Strategy & Enablement and other senior leaders to prepare executive level communications and presentations such as Board ... and report on areas of improvement and opportunities to Senior Leaders + Maintain and measure a culture of...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Albany, NY)
- …the core of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid, and other health plans to millions. By integrating insurance ... Strategy team plays a pivotal role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of the company's total revenue… more
- CenterWell (Albany, NY)
- …regulations and survey activities. + Ability to read, analyze and interpret medical documents, financial reports and legal documents. + Ability to coach/mentor ... health experience, required. Previous experience in branch leadership (Branch Director /Administrator or Clinical Manager) required. + Multi-site home health branch… more