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Multiple Accounting openings
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iWorld Professionals Rochester, United StatesAccounting Professionals Wanted - Multiple Openings at All Levels · Position Overview: iWorld Professionals is currently seeking highly motivated and skilled accounting professionals to join our talented team. As a leader in professional placement and staffing services, we are wo ...
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Cook II Multiple Openings
5 days ago
Rochester Institute of Technology Henrietta, United StatesJob Responsibilities · We want you to be part of a high-energy dining team who depends on each other to succeed. The environment is friendly but fast-paced. The goal? Nobody goes hungry, and everybody leaves smiling Our cooks are responsible for preparation and/or cooking of foo ...
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Physician Assistant Opportunity
1 week ago
Rochester Regional Health Rochester, United States Full timeWith a variety of primary care opportunities available throughout Rochester Regional Health, we are looking forward to working with you to find a practice that best fits your needs. We have opportunities in our downtown, suburban and rural practices. Each one of these provides an ...
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Travel Nurse
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Epic Travel Staffing Rochester, NY, United StatesEpic Travel Staffing is hiring a Travel RN - CVOR · Shift: Days / 9a-9:30p, 12x3, 36 hrs per week · Length: 13 weeks · 1 call and 1 DL a week with one weekend of call per month · Requirements: · NY License · 2 years of OR experience · AHA: BLS & ACLS · EMR System: EPIC · Does NOT ...
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Certified Nurse Midwife
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Rochester Regional Health Rochester, United States Full timeWe are proud to announce that we are the top hospital in our region As a Certified Nurse Midwife, your meticulous attention to detail and superior patient care is crucial in all areas of nurse-midwifery practice. This is your opportunity to join a top ranked company, and deliver ...
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RN - Med/Surg Tele
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H1B Transfer Opportunity
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CardiovVascular Operating Room
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Epic Travel Staffing Rochester, United States TravelEpic Travel Staffing is hiring a Travel RN - CVOR · Shift: Days / 6:30a-5p, 10x4, 40 hrs per weekLength: 13 weeks · 1 late shift and 1 call per week and 1 full weekend of call · Requirements:NY License · 2 years of Cardiovascular OR experience · AHA BLS, ACLS · EMR EPIC · Does N ...
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Travel Radiology Technician
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Travel technologist
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Clinical Laboratory Technologist
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Rochester Regional Health Rochester, United States Full timeRochester Regional Health's Lipson Cancer Institute is seeking a dynamic and experienced physician leader to lead our Malignant Hematology service and develop our Stem Cell Transplant programs. The Lipson Cancer Institute brings high quality cancer care right to Rochester and the ...
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Laboratory Technician IV
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Mover - Installer
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Physician Support Rep III
5 days ago
University of Rochester Rochester, United StatesOpening · Full Time 40 hours Range URCC 204 Pediatrics Pulmonology · Schedule · 8 AM-4:30 PM · Responsibilities · POSITION SUMMARY: · The Physician Support Representative III (PSR) serves as the initial contact to the Division of Pediatric Pulmonology. The PSR works with a team o ...
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Physician Support Rep III
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Senior Associate Registrar
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Rochester Institute of Technology Rochester, United StatesPosition Title · Senior Associate Registrar · Requisition Number · 8789BR · College/Division · Provost · Required Application Documents · Cover Letter, Curriculum Vitae or Resume · Employment Category · Fulltime · Additional Details · In compliance with NYS's Pay Transparency Act ...
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Sr Human Subject Res Coord
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Human Subject Res Coord II
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Physician Support Spec
5 days ago
University of Rochester Rochester, United StatesResponsibilities · **Position Summary:** · The Physician Support Specialist serves as the initial contact to the Division of Clinical Genetics, Medical (adult) and Pediatric Genetics. Position works with a team of 4-6 staff to support approximately 10 physicians and mid-level pro ...
Senior Medical Director- Multiple Openings - Rochester, United States - Excellus BlueCross BlueShield Inc
Description
** Senior Medical Director- Multiple Openings (Clinical Services, Commercial, Medicare/Retail Markets **
**Job Category****:** Medical Director **Requisition Number****:** SENIO006843 Showing 1 location **Job Details**
**Description**
New Senior Medical Director opportunities available as we add exciting leadership openings within our Medical Director space:
Senior Medical Director openings for Clinical Services (multiple openings:)
Support for Value Based Programs
Support Clinical Editing and Coding Initiatives
Senior Medical Director opening for our Commercial Line of Business supporting Univera
Support for our Buffalo market and organizational relationships
Senior Medical Director opening for our Medicare/Retail Markets Line of Business
Support for our Medicare/Retail Markets Line of Business while overseeing Quality Improvement Teams and health care measures
This position serves as deputy leader to the VP Medical Affairs and ensures achievement of strategic goals and objectives for the assigned line of business (LOB) and/or functional areas. They actively support the strategy, planning, program development and implementation of their departments portfolio.
Essential Responsibilities/Accountabilities:
In a matrixed approach, oversees and directs the work of team members and actively supports goals across all LOBs.
Routinely updates leadership team on specific issues of importance brought forward by the Health Plans Medical Directors.
Provides medical leadership, clinical consultation, and subject matter expertise specific within their scope
Serves as a clinical link to other aspects of the Medical Services Division and PHE.
Contributes to various corporate committees, initiatives, projects, or programs, as assigned.
Performs case reviews and appeals on claims and pre-authorization requests, as assigned.
Supports Provider Relations, as needed.
Works to maximize effectiveness and efficiency across all LOBs and PHE.
Participates in the annual departmental goal setting process.
Works to facilitate the achievement of the Medical Management Program goals through an effective health services delivery system.
Actively participates in the auditing of medical management processes and corrective action team projects for medical management.
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are in compliance with these requirements.
Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information.
Performs other duties and functions as assigned by management.
Minimum Qualifications:
Medical Degree, either M.D. or D.O.
Board Certification
Active NYS Medical License
Three years of supervisory and/or management experience
Three years of experience as a Medical Director for a health plan or equivalent experience
Strong verbal, written and interpersonal communication skills
Demonstrable understanding of managed care and delivery structures of healthcare
Valid NYS Drivers License
Physical Requirements:
Must be able to travel independently between the health plan regions
************
The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.
Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.
OUR COMPANY CULTURE:
Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
**Qualifications**
**Skills**
**Behaviors**
**:**
**Motivations**
**:**
**Education**
**Preferred**
Doctorate or better in Review Required.
Physician or better in Physician.
**Experience**
**Licenses & Certifications**
**Required**
Medical Doctor
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information. 41 CFR c)
