Medical Director, Utilization & Care Management
$227.6k - $385kHighmark Health
Highmark Health seeks a physician for utilization management responsibilities in Albany, NY. The role involves reviewing cases in accordance with clinical standards and participating in a multidisciplinary team for case management. Essential qualifications include an MD or DO with at least 5 years of clinical experience. The position offers a competitive salary ranging from $227,600 to $385,000, emphasizing collaboration, critical thinking, and effective communication skills. #J-18808-Ljbffr
- ...data, analytics, AI, change management, talent and sustainability capabilities... ...clients on network strategy, utilization performance, and provider... ...line strategy and site-of-care optimization (ASC vs HOPD,... ...suite of benefits including medical, dental, vision, life, and long...SuggestedFull timeLive inWork at officeLocal areaWork from home
$70.07k - $108.61k
...position provides overall administrative management of a variety of business-related functions... ...mission of high quality provision of care for patients.* Human Resources - Process... ...experienceworking in a management capacity in a medical office or clinical setting.* Must project...SuggestedWork at officeShift work$278k
...St. Peters Health Partners is seeking to recruit a full-time Nursing Home Medical Director/ Physician to lead and provide care at our nonprofit Skilled Nursing Homes in the Capital Region of Upstate New York. About The Eddy: The Eddy, located in the Capital Region...SuggestedFull timeRelocation packageShift work$227.6k
...part of a physician team, ensures that utilization management responsibilities are performed in accordance... ...cases electronically and using Medical Policy criteria sets to evaluate the medical... ...to help support and improve the care of our members. Essential Responsibilities...SuggestedPrivate practiceWork at officeLocal area$100k
...difference! Step into a Director role where your... ...employer match , along with Medical, dental, and vision insurance... ...Support Center that manages HR, recruiting, billing... ...on trauma-informed care and generational trauma... ...collaborative culture Utilize data to guide clinical...SuggestedFlexible hours- ...supervision of professional, medical and nursing staff to meet the... ...general direction of the executive director/nursing home administrator and... ...activity and data collection. Manages clinical programs focused on... ...the highest quality of care to our residents. Our mission...Full timeFlexible hours
$31.83 - $63.65 per hour
...will lead to achieved value. Manage ongoing relationships with clients... ...focusing on client success in utilizing Oracle's solutions. Through... ...which includes the following: # Medical, dental, and vision insurance,... .../Spouse/Child) # Health care and dependent care Flexible Spending...Hourly payTemporary workFlexible hours$278k
...St. Peters Health Partners is seeking a compassionate and visionary Physician Medical Director to lead medical care at Eddy Village Green in Cohoes, NY- a nationally recognized nursing home that pioneered the Green House model in New York State. This is a flexible opportunity...Full timePart timeRelocation packageFlexible hoursShift work$94.4k - $293.8k
...Responsibilities Design and implement care delivery models, workflows, and utilization management solutions Drive measurable improvements in patient flow... ...a market competitive suite of benefits including medical, dental, vision, life, and long‑term disability coverage...Work at officeLocal areaWorldwide$46.22k - $60.08k
...standardization of the patient record and utilization of clinical information system (EPIC), greeting visitors, managing the reception desk,... ...within the patient care area. The Unit Coordinator performs... ...instruction* Familiarity with Medical Terminology preferred* Basic...Work at officeFlexible hoursShift work$68.97k - $113.31k
...investigation and assessment of medical information regarding... ...medical data, to assist the Case Managers in determining claim liability... ...individuals to obtain appropriate care and ensure optimal treatment outcomes... ...the customer experience. Utilize independent vendors to perform...Temporary workWork at officeRemote workVisa sponsorshipWork visaFlexible hours- ...Association is seeking a full-time Specialty RN to provide in-home care for patients in the Troy area. Work days are typically Monday... ...role offers training in wound care, IV therapy, and disease management, with orientation and support to address the whole patient in a...Full timeMonday to FridayFlexible hours
- ...Troy Center is hiring a Registered Nurse (RN) Unit Manager in Troy, NY. Duties: Handle all supervisory duties for assigned unit Help establish... ..., offering clinical & career advice Maintain the standards of care for the unit Review Resident records & quality of care Monitor...
$26.41 - $61.79 per hour
A healthcare provider is seeking a Remote BH Care Manager LCSW, LMFT, or LMHC in New York to provide support for care management and coordination activities. The role requires at least 2 years of health care experience, preferably in behavioral health. The Care Manager...Hourly payRemote work$310k - $345k
...Medical Director Albany, NY Full-Time Leadership Opportunity Are you a board-certified... ...team, improve outcomes, and shape care delivery in a dynamic post-acute... ..., nurses, and leadership on medication management, care coordination, and quality initiatives...Full timeRelocation packageShift work- ...Troy Center is hiring a Registered Nurse (RN) Unit Manager in Troy, NY. Responsibilities Handle all supervisory duties for assigned unit... ...nurses, offering clinical & career advice Maintain the standards of care for the unit Review Resident records & quality of care Monitor...
- ...I'm working with a leading post-acute care group in Upstate New York offering full-time Medical Director of 4 locations and Assistant Medical Director positions in skilled nursing settings. Enjoy a flexible weekday schedule and strong compensation, and . Ideal for physicians...Full timeFlexible hoursWeekday work
$200k - $270k
...Center, Networking, Security, and Managed/Professional/Staffing... ...leveraging a robust portfolio, and utilizing the highest certification... ...Solutions Practice. The Practice Director serves as a senior practice... ...benefits, including medical, dental, and vision coverage;...Remote work$64.98k - $123.12k
...Behavioral Health Case Manager II – Telephonic Behavioral Health Case Manager II – Telephonic... ...individual needs and develops specific care plan to address objectives and goals as... ...psychiatric/substance abuse and/or medical disorders. Managed care experience required...Full timeTemporary workWork experience placementLocal area1 day per week- ...technology, data, analytics, AI, change management, talent and sustainability capabilities,... ...DegreeBonus points if you have: Medicaid managed care & contracting experience: Exposure to MCO... ...competitive suite of benefits including medical, dental, vision, life, and long-term...Full timeLive inWork at officeLocal area
$200k - $220k
Join Us:Shape Program Success as a Program Manager Practice Leader - Lead Delivery, Strengthen Partnerships, and Expand Impact Are you a strategic leader who thrives at the program level—balancing client relationships, operational performance, and long-term growth? Do you...$82.5k - $166.1k
...Identification: Collaborate closely with the Project Manager to proactively spot, document, and... ...which includes the following: # Medical, dental, and vision insurance, including... ...insurance (Employee/Spouse/Child) # Health care and dependent care Flexible Spending Accounts...Temporary workVisa sponsorshipFlexible hours- ...and build the case for change.Lead and develop project teams, managing delivery quality, timelines, and client relationships across one... ...provider or health system clients (e.g., hospitals, IDNs, academic medical centers).Demonstrated ability to lead workstreams and teams...Full timeLive inWork at officeLocal areaDay shift
- ...in Advisory.KPMG is currently seeking a Director, Program Integrity, Health & Human Services... ...including rate setting, cost reporting, managed care oversight, and federal claiming, to... ...Total Rewards package includes a variety of medical and dental plans, vision coverage,...H1bLocal area
- ...compassionate full‑time Registered Nurse Case Manager to join our healthcare team. In this rewarding... ...will coordinate and oversee the individualized care of patients, ensuring they receive the highest standard of medical services in their home environment. This position...Full timeWork from homeFlexible hoursDay shiftWeekday work
$190.8k - $300.3k
...We are seeking a Growth and Improvement minded Regional Medical Scientific Director (aka Medical Science Liaison, MSL) in Inflammatory Bowel... ...scientific education and dialogue Excellent stakeholder management, communication, and networking skills Thorough comprehension...For contractorsWork at officeRemote workRelocationVisa sponsorshipFlexible hoursShift work- ...Albany Medical Center is seeking a Unit Coordinator for the Emergency Department Short Stay Unit to support patient flow and service... ...will perform clerical, reception, and customer service duties, utilizing EPIC and coordinating with multidisciplinary teams. The role emphasizes...
- ...Clinical Data Management Leader Provide leadership, strategic planning, direction and implementation... ...Make decisions and chart course through careful evaluation of risks and benefits with... ...for clinical development programs with medical devices leading toward FDA filing /...
- ...Administrator for the Medicine - General department. This role provides overall administrative management, budget development, and staff leadership to ensure high-quality patient care and efficient operations. You will supervise administrative and clinical staff, oversee...
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