- Centene Corporation (Queens, NY)
- …managed care or medical group experience, provider relations, quality improvement, claims , contracting utilization management , or clinical operations. Project ... align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in… more
- University of Rochester (Rochester, NY)
- …Access Representative III (PAR) is responsible for the overall financial management and coordination for home infusion referrals including removal of barriers ... to acquire necessary information and assembly of documentation necessary to submit claims to the patient's insurance for approval including prior authorization and… more
- City of New York (New York, NY)
- …materials; managing all grant-related activities including expenditures; deliverables, fiscal claims , evaluations, and reporting; and providing guidance to partner ... providing progress reports to the State; handling program audits; and ensuring participating agency claims are paid in a timely manner. The Director will also act as… more
- Nestle (New York, NY)
- …Review and update policies and procedures as necessary related to the Safety Management program. + Ensure sites maintain continuous "audit ready" state of compliance ... as all applicable external regulatory requirements. + Initiates WC Claims to insurance provider. + Ensure all locations have... as required. + Partners with Human Resources and Management on Modified Duty review. + Follow up with… more
- HNTB (New York, NY)
- …Communicates status of schedule and key risk areas to members of project management team. + Performs schedule risk analysis, including quantitative risk analysis. + ... alternate sequencing in order to mitigate or avoid schedule delays. + Performs claims related analysis using contractor claims , delay cost estimates, time… more
- Mount Sinai Health System (New York, NY)
- …**Responsibilities** + Analyzes data requests using information technology, enrollment, claims , pharmacy, clinical, contract, medical management , financial, ... care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a...analytics related to revenue modeling, managed care contracting, population management , case management , clinical or financial decision… more
- Hannaford (Utica, NY)
- …forms if needed. * Maintain organized filing system for invoices, manual insurance claims , daily reports, etc.. in accordance with Standard Practice Manual and state ... service skills. Strong data entry and basic mathematic skills. Effective time management skills and sense of urgency. Effective interpersonal skills and ability to… more
- Axis (New York, NY)
- …of the US Casualty book. They will proactively engage with Reserving, Risk Management , Finance, Claims , and Data & Analytics colleagues to achieve desired ... identity or expression, national origin or ancestry, citizenship, physical or mental disability , age, marital status, civil union status, family or parental status,… more
- CDPHP (Albany, NY)
- …(2) years of equivalent experience required. + 1-3 years contract management experience preferred + Negotiation experience preferred + Demonstrated proficiency in ... and network adequacy requirements + Strong planning and workflow management skills with ability to shift priorities to meet...customers at all levels of authority + Understanding of claims and claims payments CDPHP salary ranges… more
- Evolent (Albany, NY)
- …member-centric products. This role plays a critical part in both **Medical Cost Management ** and **Product Management ** , leveraging advanced analytics to solve ... + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns,… more