- Elevance Health (New Hyde Park, NY)
- …Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental health and substance use disorder management, a comprehensive employee ... The **Provider Network Manager** develops the provider network through contract negotiations (language and rates), relationship development, and servicing. **How… more
- Mount Sinai Health System (New York, NY)
- …Cancer Institute's Immunotherapy program. Reviews preparation of grants, negotiations of clinical trial agreements; integrates laboratory and clinical aspects of ... as possible + Serves as liaison to Grants and Contracts , Sponsored Grant Finance and other collaborating departments +...research projects + Oversees the preparation of grants and contract submissions + Works with PIs to develop budget… more
- Claxton-Hepburn Medical Center (Ogdensburg, NY)
- …member within the inpatient adult mental health unit that will provide clinical oversight and coordination of services across a multidisciplinary treatment team. ... Claxton Crisis Intervention Training Essential Responsibilities: Required: + Collaborate with clinical leadership to develop, implement, and evaluate the social work… more
- Elevance Health (Latham, NY)
- …reviews by assessing clinical information against appropriate medical policies, clinical guidelines, and the relevant benefit plan/ contract . + May process ... ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or… more
- CVS Health (Bronx, NY)
- …development and evaluation of those procedures. **What you will do** + Recommends clinical reviews as required by federal and state regulation to company leadership. ... and objectives. + Keeps up-to date on regulations or contracts for facility types and provides written reports of...remain compliant and aligned with federal regulations * Complete clinical reviews as required by federal and state regulation… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …is directed under the terms and conditions of the various individual insurance contracts . Essential Accountabilities: Level I + Operates as a case advisor for ... based on the criteria outlined in the LTC policy ( contract ). + Develops and assists with appropriate plan of...Three (3) years combined experience in insurance and/or a clinical setting. + Active NYS RN License or bachelor's… more
- Garnet Health (Middletown, NY)
- …Doctor. Responsibilities Medical Lab Technician Performs, evaluates, records and reports clinical laboratory tests used in the diagnosis, evaluation and treatment of ... issues equitably. Medical Lab Technologist Performs, evaluates, records and reports clinical laboratory tests used in the diagnosis, evaluation and treatment of… more
- Humana (Albany, NY)
- …professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts . The ideal ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
- Humana (Albany, NY)
- …agreement with national guidelines, CMS and state Medicaid requirements, Humana policies, clinical standards, and (in some cases) contracts . The ideal candidate ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS and state policies and determinations, clinical reference… more
- Humana (Albany, NY)
- …professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts . The ideal ... and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more