- Mount Sinai Health System (New York, NY)
- …payor within the patient population; 12. Provides the clinical information requested by the managed care companies as part of the concurrent review in a timely ... fashion. 13. Provides clinical information requested by the managed care companies in accordance with contractual agreements. 14. Works collaboratively with… more
- Westchester Jewish Community Services (White Plains, NY)
- …for planning and implementing the daily, weekly, and monthly activity related to Managed Care , Medicaid and 3rd Party Insurance. This position ensures timely ... but are not limited to: + Process and review billing for Managed Care , Medicaid, and Third-Party Payers, ensuring timely claim submission, editing, transmission,… more
- Stony Brook University (East Setauket, NY)
- …Care Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials. **Job Responsibilities may ... + Educates and trains new staff regarding departmental/unit policy and procedure, including Managed Care Contracts. + Monitors work queues and staff productivity… more
- New York State Civil Service (Albany, NY)
- …NY Zip Code 12229 Duties Description The Office of Financial Management, Strategic Financial & Managed Care Group is recruiting to fill a Data Analyst 2, G-23, ... position. The Data Analytics Unit in Strategic Finance and Managed Care Group is charged with the responsibility to manage the fiscal component of several key… more
- Calvary Hospital (Bronx, NY)
- …payor within the patient population; b. Provides the clinical information requested by the managed care companies as part of the concurrent review in a timely ... fashion. c. Provides clinical information requested by the managed care companies in accordance with contractual agreements. d. Works collaboratively with… more
- Cardinal Health (Albany, NY)
- …OH. The _Director of Business Development, Market Access_ is a seasoned managed care executive and strategic individual contributor responsible for developing ... contract lifecycle. + Serve as the external subject matter expert on managed care , value-based payment methodologies, and population health trends, leveraging… more
- Molina Healthcare (Yonkers, NY)
- …+ 2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare ... discuss and resolve issues related to utilization management, pharmacy, quality of care , and correct coding, for example. + Independently delivers training and… more
- Molina Healthcare (Brooklyn, NY)
- …eligible recipients for enrollment into Government Programs such as Medicaid/Medicaid Managed Care , Child Health Plus and Essential Plan. Additionally, ... in selection of the appropriate health plan. The Enroller provides information on managed care programs and how to access care . The MFE is responsible… more
- Trinity Health (Troy, NY)
- …via computer. Pre-authorization and case management is done with reviewers at the Managed Care Organization that is responsible for approving a client's ... those determinations are made, presenting the clinical cases to insurers and managed care companies to secure authorizations for admission to treatment at the… more
- New York State Civil Service (New York, NY)
- …protocols.* Analyze data and arguments to make well-reasoned determinations for Medicaid managed care reviews.* Apply Medicaid policy, regulations and Medicaid ... managed care contracts to reviews.* Prepare well-written and accurate audit...ability to learn new data systems.Familiarity with the Medicaid Managed Care /Family Health Plus/HIV Special Needs Plan… more