- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: In constant pursuit of improving quality outcomes for the Health Plan , this position exists to retrieve and abstract data from medical ... and Certified NCQA auditors. Physical Requirements: + Ability to travel across the health plan service regions as needed. One Mission. One Vision. One IDEA One… more
- Reynolds American (Albany, NY)
- … Health Savings Account start-up contribution for employees who elect the high deductible health plan . + Flexible spending accounts for both Health Care ... and Company goals. + Develops a local strategy and business plan for meeting individualized territory objectives, including identifying, analyzing, prioritizing, and… more
- Kelly Services (Rochester, NY)
- …The Technician serves as a resource for staff on members' contract benefits, related health plan functions, and provides leadership in the intake area of the ... using online tools and resources + Maintain thorough knowledge of health plan contract information and assist colleagues + Perform workflow processes in… more
- BriteLife Recovery (West Kill, NY)
- …Kill, NY. What we provide you!! + Comprehensive Benefits Package: Enjoy a fully sponsored Health plan through APA with Cigna Network, ensuring your health ... talented and caring, authentic individuals to create a world-class mission-centered behavioral health organization, focused on doing it the right way If you really… more
- Evolent (Albany, NY)
- …received via phone, fax, or email in accordance with regulatory requirements and health plan guidelines. + Conduct research and analysis of case documentation, ... Coordinator role or other relevant experience gained through roles with a health plan , managed care organization or third-party administrator is required. + 2… more
- City of New York (New York, NY)
- …providers whenever the insurance company indicates that a client is not part of their health plan ; ensure SDOH reinstates the client to their previous health ... ASSOCIATE CIVIL SERVICE TITLE. The Medical Assistance Program (MAP) administers public health insurance programs, including Medicaid, for the City of New York.… more
- Molina Healthcare (NY)
- …program. Supports integrated duals product development in collaboration with enterprise and health plan teams. Supports integrated teams in continual process ... and strategic objectives. + Serves as a duals SME for enterprise and health plan teams in developing Go-To market strategies. + Leads and supports integrated… more
- Molina Healthcare (Albany, NY)
- …**Job Summary** The Manager, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues ... multiple Molina Healthcare products. Analyzes data and dashboard reports to monitor health plan performance and identify the root causes of medical cost trends.… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- …key community organizations and coordinates efforts to participate, educate and promote the health plan presence within the community . Develop and implement ... early intervention, counseling and referrals to therapeutic mental and behavioral health treatment to children, adolescents, young adults, and their families. The… more
- Humana (Albany, NY)
- … health insurance, evaluating medical necessity and appropriateness of care + Health Plan experience + Previous Medicare/Medicaid Experience a plus + ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical...year This job is eligible for a bonus incentive plan . This incentive opportunity is based upon company and/or… more