- The Cigna Group (New York, NY)
- …go into the NYC office two times per month._** The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and reports to ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- Healthfirst (NY)
- …peers to establish goals, priorities and deliverables of Business/ Project Analyst team. Ensurelong-term strategic and short-term tactical Operational needs for ... ensure their own optimal performance as well as performance of the Business/Project Analyst team. + Regularly meet with supervisor, peers, and stakeholders to drive… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …have hands on experience in setting and managing large complex projects in Healthcare Insurance across business, operational, and IT teams, spanning one or more work ... streams, including: Client Implementation, Enrollment & Eligibility, Claims processing & Reimbursements, Member/Provider self-service, Customer Service, Legal etc.… more
- CVS Health (Albany, NY)
- …every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within ... role, you will manage complex investigations into suspected and known acts of healthcare fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level,… more
- Highmark Health (Albany, NY)
- …and/or create analytics and reporting solutions aligned to the Quadruple Aim of Healthcare : lower per capita health care costs, improved outcomes from and quality of ... to identify, develop and/or monitor actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and… more
- TEKsystems (Hicksville, NY)
- …Billing or Hospital Billing module to manage charges, benefit engines, claims , and payment processors. * Workflow Analysis and Improvement: Analyze workflows, ... and Data Analysis: Develop and generate reports to extract and analyze healthcare data. * Training: Collaborate with trainers on application changes and new… more
- CVS Health (Albany, NY)
- …setup, essential for online viewing and processing, related to customer service, claims , enrollment, billing, and reporting, in support of internal and external ... level benefits to align with industry coding (ICD 10, place of service, healthcare reform, etc.), similar to entry-level IT programming. + Solicits and assesses… more
- Bowery Residents Committee (Manhattan, NY)
- …Highly proficient with Microsoft Office tools. + Prior knowledge of electronic claims processing would be preferred. *Vaccination preferred but not required. MAKE AN ... for career development. + Flexible spending accounts (FSAs) are available so employees can set aside pre-tax dollars for healthcare , transit and childcare. more
- Molina Healthcare (Albany, NY)
- …trends, payment integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Healthcare Risk Management** **FT Days- M-F onsite** RNs, Pharmacists, Social Workers ... healing presence within our communities. **POSITION SUMMARY** The Clinical Risk Management Analyst is responsible for the overall patient safety and clinical risk… more