- CVS Health (Albany, NY)
- …Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection, investigation, and prevention efforts to safeguard ... Stay informed about changes in the industry practices related to healthcare coding . Provide training opportunities for staff to maintain their CEUs. Assist in… more
- Evolent (Albany, NY)
- …mission. Stay for the culture. **What You'll Be Doing:** Seeking a detail-oriented ** Clinical Rules Management, Associate Director** who will play a critical role in ... ensuring the accuracy and integrity of our clinical rule engine, impacting our clinical review...excellent interpersonal skills + Knowledge of ICD-10-CM and CPT coding assignments for billing in an outpatient or physician… more
- Molina Healthcare (Albany, NY)
- …4 weeks Monday-Thursday and Wed - Saturday._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical ... decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical reviews of… more
- Kaleida Health (Buffalo, NY)
- **Director Clinical and DRG Denials** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 Job ... Description **Summary:** The Director, Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical Revenue Cycle… more
- VNS Health (Manhattan, NY)
- OverviewLeads the clinical audit team and oversees quality improvement initiatives with a primary focus on Medicare STARS and clinical program performance for ... member engagement, and audit oversight. This role will be the primary clinical point of contact for STARS and quality initiatives while supporting strategic… more
- Mount Sinai Health System (New York, NY)
- …is seeking a highly motivated clinically trained post-doctoral fellow to conduct clinical and translational research!** The Icahn School of Medicine at Mount Sinai ... seeking a highly motivated clinically trained post-doctoral fellow to conduct clinical and translational research in psychosis spectrum disorders or mood disorders.… more
- Elevance Health (East Syracuse, NY)
- ** Clinical Review Nurse I - Medicare Part B** National Government Services is a proud member of Elevance Health's family of brands. We administer government ... 5 pm EST or CST. Hours are flexible. The ** Clinical Nurse Reviewer I** is responsible for reviewing and...+ Proficient in basic math calculations with percentages. + Coding certification or experience with medical coding … more
- Fresenius Medical Center (Rochester, NY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Trinity Health (Albany, NY)
- …part of a team to support our field clinicians through education, assists with coding , and other quality duties as assigned. This position is exempt, working 40 ... team members. **Responsibilities:** + Responsibilities include development and oversight of clinical , quality and educational programs and activities. + Facilitate … more
- Lake Erie College of Osteopathic Medicine (Elmira, NY)
- Osteopathic Principles and Practice Clinical Faculty - College of Medicine Overview Date Posted: 4/22/2025 Location: Elmira Address: 1 LECOM Place City: Elmira ... Education Employment Status: Full-time Description JOB SUMMARY: Osteopathic Principles and Practice Clinical Faculty are well versed and experienced in all phases of… more