- Cardinal Health (Albany, NY)
- …(ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing legal ... between payer and provider(s) to ensure optimal reimbursement including managed care contracting , enrollment, credentialing,...with strategy. **Essential Functions:** + In collaboration with the Director of Managed Care , negotiate… more
- Albany Medical Center (Albany, NY)
- …and payer relationships. + Demonstrated knowledge of current federal and NYS regulations regarding managed care contracting , as well as the provision and ... employee related activities, as applicable, under the System Payer Contracting Unit. The Director prepares annual budget...all federal, state, and local regulations for governing payer contracting , stays informed of the health care … more
- Molina Healthcare (Yonkers, NY)
- …QUALIFICATIONS:** + At least 8 years of experience in Healthcare Administration, Managed Care , and/or Provider Network Management and Operations with an ... subject matter expertise for the design and implementation of value-based care programs across Medicaid, Medicare, and Marketplace populations, ensuring alignment… more
- Catholic Health (Buffalo, NY)
- …Additionally, in collaboration with CH, the Director Financial Services collaborates with managed care to ensure accurate managed care pricing ... from Overtime: Exempt: Yes Work Schedule: Days Hours: 8a-4p Summary: The Director Financial Services, Physician Enterprise serves as the finance executive for… more
- Kaleida Health (Buffalo, NY)
- …outlook required. 8 years of experience in multi- hospital system and / or managed care required. 10 years of experience in Federal, state and accreditation ... ** Director Clinical and DRG Denials** **Location:** Larkin Bldg...methodologies, coverage issues, documentation, coding conventions and insurance / managed care practices including but not limited… more
- Aspen Dental (Albany, NY)
- …This role will play a key part in supporting our managed care operations and strategic payor initiatives. The Director will ensure data accuracy, ... created an opportunity to join our team as a Director , Data Management. Aspen Dental is seeking a highly...data extraction, transformation, and analysis. + Deep understanding of managed care operations, including provider and facility… more
- Molina Healthcare (Buffalo, NY)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Weill Cornell Medical College (New York, NY)
- …cost-benefit analyses for proposed research initiatives and investments as well as managed care contracting negotiations with NewYork-Presbyterian. Present ... Title: Director , Research Finance & Analysis Location: Midtown Org...medical center that is committed to excellence in patient care , scientific discovery, and the education of future physicians… more
- Highmark Health (Albany, NY)
- …Insurance, Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population ... drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark Health… more
- Molina Healthcare (Yonkers, NY)
- …+ 10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization decisions are...Director + Demonstrated experience in Utilization/Quality Program management +… more