- Humana (Albany, NY)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …field. Minimum of two (2) year's relevant and progressive business experience working in managed care or other health care related field with significant ... + Minimum of 4 year's relevant and progressive business experience working in managed care or other health care related field with significant interface with… more
- Humana (Albany, NY)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Molina Healthcare (Yonkers, NY)
- …health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Advanced proficiency with retrieving specified ... utilized in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Healthfirst (NY)
- …**Work experience within the healthcare industry** + **Experience with Medicare or Medicaid managed care plan products such as, Family Health Plus (FHP), Eastern ... a healthcare environment.** + **Healthfirst product knowledge of Complete Care , Senior Health Partners (SHP) or managed ...Complete Care , Senior Health Partners (SHP) or managed long-term care .** + **Prior experience engaging… more
- Mount Sinai Health System (New York, NY)
- …effectively. . Organize routine meetings with health system business leaders and managed care teams to review authorization performance, payer issues, and ... relationships with key stakeholders across departments (eg, DTP, Human Performance, Managed Care , Finance, and clinical departments). . Collaborate with… more
- Mount Sinai Health System (New York, NY)
- …+ Opportunity to work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is responsible for the negotiation, ... related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more
- Humana (Albany, NY)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Mount Sinai Health System (New York, NY)
- …+ Opportunity to work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is responsible for the negotiation, ... related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more
- Mount Sinai Health System (New York, NY)
- …clinical, contracting, finance, IT, analytics, operations, and product development expertise. The Managed Care Contracting Team within MSHP is responsible for ... related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more