- Centers Plan for Healthy Living (New York, NY)
- …department and assists with the care of all members enrolled in CPHL's managed care plans. The Field Coordinator schedules and completes in-person visits as ... to detail and multi-tasking skills Preferred: + Experience working in managed care environment + Experience working with geriatric population + Bilingual… 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
- Mount Sinai Health System (New York, NY)
- …and governmental programs, regulations, and billing processes (eg, Medicare, Medicaid, etc.), managed care contracts and coordination of benefits is required. ... government payers, applicable federal and state regulations, healthcare financing and managed care . + Expected to stay updated on current medical billing and… more
- Mount Sinai Health System (New York, NY)
- …Analyst initiates systems to capture all inpatient and outpatient charges. Monitors managed care , commercial and federal contracts to assure the recovery ... services. Assures that updated fee schedules for Medicare, Medicaid, commercial and managed care carriers are correctly entered in the billing system. + Analyzes… more
- Mount Sinai Health System (New York, NY)
- …colleagues + Must have excellent verbal communication & listening skills + Knowledge of managed care plan requirements + Ability to organize and prioritize and ... assist them in navigating MyChart. + May acquire insurance pre-authorization/referrals from managed care plans for all required services, admissions, procedures,… more
- Outreach Development Corporation (Ridgewood, NY)
- …relationships with referents and other collateral contacts (ie, Probation, Parole, CPS, managed care , EAP's, courts, etc.) through timely written, phone, ... services. . Conduct toxicology testing as needed. . Oversee and/or coordinates care with managed care organizations of identified clients who need either… more
- Healthfirst (NY)
- …Qualifications: + Masters degree in a related discipline + Experience in managed care , case management, identifying alternative care options, ... York State + Department of Health (NYSDOH) regulations governing medical management in managed care + Relevant clinical work experience + Intermediate Outlook,… more
- CenterWell (Albany, NY)
- …required. + Familiar with CAQH + Bilingual; English & Spanish + Experience in managed care or health care administration desired **Additional Information** + ... regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional… more
- Mount Sinai Health System (Greenlawn, NY)
- …regarding policies and procedures, billing related training, contractual relationships with managed care organizations, capital procurement and space allocation. ... are resolved. + Coordinates planning and implementation of contractual relationships with managed care organization. + Reviews and evaluates manual and… more
- Mount Sinai Health System (New York, NY)
- …sets, Epic edits, and reimbursement. + Capacity to review, analyze and interpret managed care contracts, billing guidelines, and state and federal regulations ... ensure they align with payer regulations, Medicare/Medicaid reimbursement methodologies, and managed care contracts. + Provides routine, standardized reporting… more