- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and Workers' Compensation and ... patients, employers, providers, and claims adjusters to coordinate medical and disability services for timely return to work. + Provides case management,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …for the following programs, including but not limited to: * Prospective medical record review of health plan providers * Retrospective medical record review of ... were correctly reimbursed and documented. Reports findings of the data validation review . Prepares and submits adjustments to the appropriate processing / adjustment… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …regulatory mandates related to the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes ... as needed, at the time of the annual performance review + Non-care manager support staff duties may include:...regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability , or status as a protected… more
- City of New York (New York, NY)
- …HPDTech to outline technical issues and make program recommendations. Your Role: - Review and approve HQS enforcement actions processed by HQE specialists to verify ... the consistency and accuracy of their work - Review fiscal HAP adjustments to ensure that Hap payments are authorized - Works with HPD Info and Section 8 Elite… more
- Deloitte (New York, NY)
- …responsibilities will be performing tasks across the contract lifecycle, including contract review , drafting, and playbook enabled negotiation. As a team member, you ... quantitative (ie contract request turnaround time) and qualitative (ie contract review and drafting accuracy) key performance indicators. You will embrace… more
- University of Rochester (Albany, NY)
- …written and verbal communication and customer service skills. **_Financial Management_** + Review each visit for insurance history by utilizing the hospital system ... for adequate benefit coverage and eligibility throughout the inpatient stay. + Review payer denials and communication from PFS related to Health Insurance Counseling… more
- City of New York (New York, NY)
- …of contract managers responsible for non-human Services contracts. - Review contract proposals for services including Food, Exterminating, Cleaning, Transportation ... guidelines. - Assist with Intra City Memorandum of Understanding (MOUs). - Review and approves invoices for contracts in their portfolio to ensure accurate… more
- Heritage Financial Credit Union (Middletown, NY)
- …with ALL State and Federal rules, regulations and laws. + Periodically review policies and procedures (especially changes) to ensure they meet regulatory ... Risk and Compliance to develop the Credit Union's annual departmental testing and review plan with a strong focus on Lending Compliance. + Monitor various indicators… more
- Sunrise Senior Living (Dix Hills, NY)
- …to engage in Life Skills or other life enrichment activities daily. + Review resident profile and the Individualized Service Plan (ISP) and spend time talking ... the Life Skills program and services. **Resident Focus** + Review , read, notate, and initial the Daily Log and...compensation that include: + Medical, Dental, Vision, Life, and Disability Plans + Retirement Savings Plans + Employee Assistant… more
- Mount Sinai Health System (Smithtown, NY)
- …practice agreement in the specific clinical area and performs a periodic review of the collaborative agreement. 3.Assesses the health status of patients/families by ... interdisciplinary approach to acute/primary health care delivery. 10.Performs a patient record review with the collaborating physician in a timely fashion but not… more