- Molina Healthcare (Albany, NY)
- …integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape ... years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, or equivalent combination of relevant… more
- Access: Supports For Living (Middletown, NY)
- …We seek an Accountant specializing in Behavioral Health insurance billing and Medicaid Managed Care billing. The ideal candidate will have expertise in Net ... staff and leadership regarding financial matters. + Ensure compliance with Medicaid Managed Care and Behavioral Health insurance billing regulations. + Utilize… more
- Molina Healthcare (Buffalo, NY)
- …and strong system knowledge of QNXT and other state specific applications concerning Managed Care Enrollment. + Responsible for ensuring timely reconciliation of ... education and experience **Required Experience** 5-7 years Enrollment-related experience in Managed care or Medicare setting **Preferred Education** Graduate… more
- Highmark Health (Albany, NY)
- …federal and state rules as well as a solid working knowledge of managed care operations, compliance program structures, information security and audit ... in leading interdepartmental and cross-functional strategy development. + Experience with managed care , Medicare and federal and/or state regulations, quality… more
- Centene Corporation (Poughkeepsie, NY)
- …including "metal" products offered through the New York State of Health (NYSOH), Medicaid Managed Care , Child Health Plus, Medicare, MLTC, FIDA and HARP. Ability ... diploma or GED, required. 2 to 5 years prior experience in managed care , sales, customer service or related experience preferred. Basic computer skills. Driver's… more
- Centene Corporation (Queens, NY)
- …claims processing or utilization and case management in a clinical practice or managed care organization. Experience analyzing various types of data and ... or as a staff nurse in an acute, sub-acute or long-term care (LTC) setting or managed long-term care plan (MLTCP); Geriatrics, Medical Surgical Nursing, Case… more
- Elevance Health (Latham, NY)
- …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. For candidates ... be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care management within the scope of licensure for members with complex and… more
- Mount Sinai Health System (New York, NY)
- …strong, collaborative relationships with cross-functional stakeholders including DTP, Human Performance, Managed Care , Finance, and clinical departments. * Work ... with finance and managed care teams to improve registration, coding, and billing accuracy and performance. * Support clinical leaders and administrators by… more
- Molina Healthcare (Albany, NY)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …proficiency + Strong multi-tasking abilities Preferred: + Experience working within a managed care environment + Experience working with the geriatric population ... a multidisciplinary care team to help assist with the care of members enrolled in CPHL Managed Long Term Care program and other LOBs to facilitate,… more