- Evolent (Albany, NY)
- …cost and use trends, and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value of new and existing ... fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- Molina Healthcare (New York, NY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... improvement processes to ensure systems are working more efficiently and improve quality . + Assists in planning and coordination of application upgrades and… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …work streams, including: Client Implementation, Enrollment & Eligibility, Claims processing & Reimbursements, Member/Provider self-service, Customer Service, Legal ... resource planning. + Manage various file integrations including eligibility, accumulators, claims , etc. + Create an efficient process to manage client… more
- Highmark Health (Albany, NY)
- …of Healthcare: lower per capita health care costs, improved outcomes from and quality of care received, and optimal member/patient and provider experiences with care ... actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to… more
- St. Mary's Healthcare (Amsterdam, NY)
- …law. Responsibilities: * Interpret and analyze data from multiple sources including claims , provider, patient, and encounters data. Identify and assess the business ... improvement opportunities (proactive and reactive). Continually strive to improve quality by identifying areas of potential risk and recommending improvement… more
- World Insurance Associates, LLC. (Syosset, NY)
- …cases + Create monthly financial reporting packages including detailed premium, claims , membership, commission, and cash reconciliation information + Create weekly, ... format + Proven ability to manage multiple projects simultaneously and produce quality deliverables on time + Possess strong administrative and computing skills,… more
- City of New York (New York, NY)
- …public health for all New Yorkers by providing 1.1 billion gallons of high- quality drinking water, managing wastewater and stormwater, and reducing air, noise, and ... Services (PS) Unit, the Other than Personal Services (OTPS) Unit and the Revenue & Claims Unit. Candidates will be assigned to a unit based on need. Candidates must… more
- CVS Health (Albany, NY)
- …And we do it all with heart, each and every day. **Position Summary** Claim Audit Quality Analyst is responsible for ensuring the accuracy and quality of ... multiple areas within Meritain. This role demands a deep understanding of claims , plan documents, eligibility, coverages, and the unique requirements of various… more
- Mount Sinai Health System (New York, NY)
- …a team of compliance analysts, including the Senior Contract Compliance Analyst , to ensure ongoing contract compliance monitoring, risk identification, and issue ... law, and the revenue cycle, with particular focus on PB and HB claims . o Understanding of the legal and regulatory environment surrounding healthcare contract… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE STAFF ANALYST CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9. The Department of ... operation of the Office of Audit Services (OAS) and Office of Quality Assurance (OQA), Office of Accountability Strategies (OAS), Compliance and Contract Monitoring… more
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