- Molina Healthcare (Yonkers, NY)
- …analytics and reporting solutions that help track, measure, and optimize automated claims processing solutions. The role will leverage tools like Power BI, Azure ... reporting to track solution effectiveness and surface potential issues + Creating claims impact reporting to assess automation potential, issues or financial impact… more
- KPH Healthcare Services, Inc. (Syracuse, NY)
- …for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate financial and clinical ... for services. **Travel** : Limited travel may be required. Travel to healthcare providers and to various business and management conferences required. Travel to… more
- Molina Healthcare (Yonkers, NY)
- …responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other Core Ops areas of ... maintains an effective, consistent Vendor Management function + Supervise Molina Healthcare vendor management staff + Ensures departmental and individual performance… more
- Molina Healthcare (Albany, NY)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Molina Healthcare (Albany, NY)
- …Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of ... software and medical record vendors, and other Molina departments, such as Claims , Enrollment, IT etc,. to get appropriate responses and manage contracts and… more
- Molina Healthcare (Albany, NY)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other...Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in Healthcare … more
- Molina Healthcare (Syracuse, NY)
- …of encounters as well as provides leadership support at managing overall healthcare costs. + Ability to influence across multiple organizational functions - Payment ... Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in...increase operational efficiency, and effectiveness. **Knowledge/Skills/Abilities** + 8+ years Healthcare or Operational experience in related job. + 2… more
- Molina Healthcare (Albany, NY)
- …network adequacy and provider training and education, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance with ... staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for...3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5… more
- Molina Healthcare (New York, NY)
- …network adequacy and provider training and education, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance with ... staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for...3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3+… more
- Bassett Healthcare (Cooperstown, NY)
- …oversee and coordinate the design, planning, and construction at healthcare facilities (including infrastructure upgrades) across Bassett's multi-site network. This ... care, operational efficiency, and full regulatory compliance with New York State healthcare standards. The ideal candidate will bring deep expertise in healthcare… more