- City of New York (New York, NY)
- …support the delivery of high-quality, effective, and impactful contracted services. The Deputy Director of the Office of Contract Agency Audits will report to OCA's ... Director and will oversee one or more Senior Auditors....independently audited financial statements. - Conducting reviews of monthly claims for reimbursement submitted by CBOs, as part of… more
- Centene Corporation (New York, NY)
- …+ Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Molina Healthcare (Albany, NY)
- …IL, OH, ID, SC, UT, WI, MA, NV, IA, GA + Active AZ MD license **Job Duties** + Provides medical oversight and expertise in appropriateness and medical necessity of ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Gilead Sciences, Inc. (Syracuse, NY)
- …the lives of patients with life-threatening illnesses worldwide. The Regional Director , Sales HIV Treatment Upstate NY/NJ is responsible for representing Gilead's ... and a proven record of sales success via multiple award recognition. The Regional Director should have the ability to synthesize various market data sources to guide… more
- New York Power Authority (White Plains, NY)
- Director , Research & Development Location: White Plains, US **Summary** Leads research, design, and development activities to improve NYPA's energy services. ... and invoice documentation relating to projects. Evaluate and approve all change order claims and payment invoices. Work as a team member with other engineers inside… more
- Citigroup (New York, NY)
- The Director , HR Legal is a Senior Lead Counsel 2 (Employment & HR) role and is a senior level position responsible for serving as subject matter expert and key ... Serve as a partner and advisor on employment contracts, claims of discrimination, and employment-related arbitration + Advise on...ability to build and maintain trusted relationships + Bar license in good standing to practice law **Education:** +… more
- Centene Corporation (New York, NY)
- …to providers that would improve utilization and health care quality. + Review claims involving complex, controversial, or unusual or new services in order to ... treating or managing care for a culturally diverse population preferred. ** License /Certification:** Board certification in a medical specialty recognized by the… more
- Molina Healthcare (Syracuse, NY)
- …with AI Data Integration._** + **_Experience with Member, Enrollment, and Claims applications -_** **which underpin essential business functions such as HEDIS ... **_Azure Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License , Certification, Association** Microsoft Technology, Mobility, ITIL To all… more
- Stony Brook University (Commack, NY)
- …Care Provider Enrollment Specialist, you will work under the oversight of the Director of Managed Care Enrollment and join a team of professionals representing Stony ... are to be enrolled within ninety (60) days of roster submission. Inform Director of Enrollment of MCOs non-compliance. A provider enrollment roster should be sent,… more
- Sunrise Senior Living (Glen Cove, NY)
- …internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate ... process candidates in the ATS system and perform background screenings, license verifications, and other required screenings/verifications per applicable federal and… more