- Evolent (Albany, NY)
- …outcomes and a more connected care journey. We are hiring for a Managing Director , Actuarial Services to join our Finance Team. The candidate selected for this role ... to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication to key… more
- Robert Half Finance & Accounting (New York, NY)
- …those most impacted by social determinants of health. Our client is seeking a Director of Finance to serve as a strategic and hands-on leader, reporting directly to ... . Lead revenue cycle management and ensure accurate billing, coding, and claims across Medicaid, Medicare, and private insurers . Guide long-term financial strategy… more
- Danaher Corporation (New York, NY)
- …System (https://www.danaher.com/how-we-work/danaher-business-system) which makes everything possible. The Senior Director of Data & AI is responsible for the ... analyses, and data visualization. + Proven experience with RWE/RWD (EHR, claims , registries, labs/device telemetry) to inform clinical, regulatory, and market access… more
- Ankura (NY)
- …structured, defensible processes for fiduciaries, courts, and stakeholders in high-volume claims environments. Role Overview The Trust and Mass Torts Senior Managing ... Director role is an executive level position that sells, leads and manages complex client engagement(s). The successful candidate will be a "person of stature" and… more
- WTW (Buffalo, NY)
- …phone and face to face with clients. + Champion the proper advocacy of claims . + Participate in stewardship meetings. + Support Client Management team in identifying ... and closing rounding opportunities. **Pipeline Management:** + Identify prospects for business from existing and prospective clients. + Develop new relationships with individuals responsible for insurance and risk management decisions. + Obtain referral leads… more
- Fresenius Medical Center (New York, NY)
- …project specifications and review methodologies. Analyses will include review of claims data, analysis of medication utilization for global contracts and analysis ... of rate structure conversion. + Consolidates patient insurance download data including developing standards for field review of data and reporting. + Provides consolidated business / payer mix / revenue by payer / treatment mix on a monthly basis including… more
- Molina Healthcare (Yonkers, NY)
- …focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. ... * Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics (P&T) and other committees as directed by the chief medical officer. * Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring… more
- Kyndryl (Albany, NY)
- …Partner with CCaaS architects to build future-proof architectures with EHR, CRM, and claims system integrations. The compensation range for the position in the US is ... $159,240 to $286,560 based on a full-time schedule. Your actual compensation may vary depending on your geography, job-related skills and experience. For part time roles, the compensation will be adjusted appropriately. The pay or salary range will not be… more
- City of New York (New York, NY)
- …program administration. - Utilizing automated systems and tools to verify that claims submitted to Grantors are accurate and timely. - Reviewing and reconciling ... provider invoices in PASSPort against approved budgets to confirm accuracy prior to submission. - Conducting grant eligibility reviews to ensure compliance and assess impacts on Personnel Services (PS) and Other Than Personnel Services (OTPS) budgets. -… more
- WMCHealth (Poughkeepsie, NY)
- …an aberrant practice pattern, a potential lawsuit, etc.) and alerts the department director , medical staff leadership, and claims manager. + Conducts special ... pattern, a potential lawsuit, etc.) and alerts the department director , administration, and the claims manager. Initiates a more thorough review to clarify the… more