- University of Rochester (Rochester, NY)
- …and adjudication, including refund of credits + Review and advise supervisor or manager on trends of incorrectly paid claims from specific payers + Work with ... supervisor/ manager on communication to payer representatives regarding payment trends...looking for a career in higher education or health care , the University of Rochester may offer the perfect… more
- Molina Healthcare (Syracuse, NY)
- …QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either at a health ... able to confirm outcomes meet the specific state/federal requirements. + Assists manager in establishing standards, guidelines, and best practices for the audit team… more
- Saratoga Hospital (Saratoga Springs, NY)
- Behavioral Health Care Manager -Collaborative Care Salary Range: $55,000-$75,000/year based on experience and qualifications About Saratoga Hospital At ... the Role We're looking for a dedicated Behavioral Health Care Manager -Collaborative Care to join...record. + Flexibility and adaptability to both in-person and remote work settings. Why Saratoga Hospital + A caring,… more
- Sharecare (Albany, NY)
- …individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com ... CST. **Job Summary:** Under the general supervision of a Customer Service Manager , the Program Engagement Representative has the primary responsibility of making… more
- Guardian Life (Albany, NY)
- …full tme, remote -based position. **Position Summary** Guardian's Annuity New Business CARE team seeks a dynamic and knowledgeable individual to join our team as ... an **Annuity Relationship Manager ** . We are looking for someone with exceptional...internal and external partners. As a member of our CARE Team, you are part of a dynamic group… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Care Manager , Telephonic Behavioral Health 2, in a telephonic environment, assesses and ... the care and wellbeing of members The Care Manager , Telephonic Behavioral Health 2 is...the first 90 days; any/all exceptions are at the manager 's discretion Travel: While this is a remote… more
- Molina Healthcare (Rochester, NY)
- …review and/or Provider appeals and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS ... experience with appeals/grievance and/or claims processing within a managed care setting. **Preferred Education** Bachelor's degree Previous Director experience. To… more
- Chobani (NY)
- …and inventory analysis. * Act as a subject matter expert and project manager for key operational initiatives. * Scenario modeling and risk mitigation Team Leadership ... reimbursement. We are also proud to offer specialized benefits like health care navigation, mental health services, fertility assistance, and paid parental leave as… more
- Rochester Regional Health (Rochester, NY)
- …This position will not be employed by Rochester Regional Health (RRH). SUMMARYThe RN Care Manager will provide direct patient support both in-person and ... remote . They will be responsible for orchestrating ...and educating patients on chronic condition management. The RN Care Manager will act as part of… more
- FlexStaff (Flushing, NY)
- …Number** 158924 Full-Time, Monday-Friday, 8:30AM - 5:00PM. In Office/Clinic; no remote /hybrid. JOB PURPOSE: Responsible for supporting the nursing standards of ... excellence with advance professional education to deliver high-quality care . Serve the organization as a member of the...the Virtual IDT as needed. - Serve as a manager on call during non-operational hours of the physical… more