• Field Clinical Specialist , New York…

    Edwards Lifesciences (New York, NY)
    Make a meaningful difference to patients around the world. As a part of the Field Clinical Specialist team, you will be a critical part of delivering our patient ... healthier lives. Join us and be part of our inspiring journey. **_Note: this Clinical Specialist will support field cases for EVOQUE (tricuspid device) in the… more
    Edwards Lifesciences (08/23/25)
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  • Care Manager - Readmission Specialist

    Stony Brook University (Stony Brook, NY)
    Care Manager - Readmission Specialist **_Position Summary_** _At Stony Brook Medicine the_ Care Manager - Readmission Specialist _must have both hospital and ... readmission. The RN following these patients must have good clinical and communication skills to address the needs of...of excellence._ Duties of a Care Manager - Readmission Specialist may include the following but are not limited… more
    Stony Brook University (07/15/25)
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  • Compliance Auditing Specialist

    WMCHealth (Valhalla, NY)
    …and educational efforts. Tracks and reports on the effectiveness of the clinical documentation improvement program through record keeping and results analysis. ... . Maintains current competencies in clinical documentation improvement and ICD, CPT and HCC coding through continuing education. Assists with compliance audits… more
    WMCHealth (07/09/25)
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  • Senior Specialist , Member & Community…

    Molina Healthcare (NY)
    **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member ... key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes. Acts as a lead … more
    Molina Healthcare (07/31/25)
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  • Health Systems Specialist 2 (Social Work)…

    New York State Civil Service (Central Islip, NY)
    NY HELP Yes Agency Health, Department of Title Health Systems Specialist 2 (Social Work) (NY HELPS) - 46672 Occupational Category Health Care, Human/Social Services ... NY Zip Code 11722 Duties Description With an eye toward continuous quality improvement , the incumbent will serve the Metropolitan Regional Office on our Central… more
    New York State Civil Service (08/14/25)
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  • Revenue Integrity Charge Specialist Fully…

    Trinity Health (Syracuse, NY)
    …complete documentation to ensure revenue optimization and integrity.Performs outpatient clinical documentation improvement review (acute only) as needed.Performs ... billing. Strong understanding of various medical claim formats.Knowledge of clinical documentation improvement processes strongly preferred.Strong knowledge of… more
    Trinity Health (08/02/25)
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  • Revenue Integrity Charge Specialist Fully…

    Trinity Health (Syracuse, NY)
    …complete documentation to ensure revenue optimization and integrity. Performs outpatient clinical documentation improvement review (acute only) as needed. ... billing. Strong understanding of various medical claim formats. Knowledge of clinical documentation improvement processes strongly preferred. Strong knowledge of… more
    Trinity Health (08/02/25)
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  • Referral Specialist Orthopedics & Spine

    Trinity Health (Syracuse, NY)
    clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist . + Call patient with appointment ... .To be world-renowned for passionate patient care and outstanding clinical outcomes. **Core Values:** .In the spirit of good...and quality delivery of care. + Participate in quality improvement initiatives as part of the practice care team.… more
    Trinity Health (08/19/25)
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  • Professional, BH Program Support Specialist

    MVP Health Care (Rochester, NY)
    …healthier future for everyone - which requires innovative thinking and continuous improvement . To achieve this, we're looking for a **Professional, BH Program ... Support Specialist ** to join #TeamMVP. If you have a passion...and follow-up on tasks and assignments + Ability to document phone calls/emails/chats in a professional manner + Ability… more
    MVP Health Care (08/14/25)
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  • Claim Dispute Specialist

    Brighton Health Plan Solutions, LLC (New York, NY)
    …Brighton Health Plan Solutions (BHPS) is seeking an experienced Claim Dispute Specialist skilled in investigating and resolving provider payment disputes by our ... + Thorough review of claims and medical documentation. + Prepare cases for clinical review. + Resolve and provide accurate and timely responses to disputes and… more
    Brighton Health Plan Solutions, LLC (06/05/25)
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