- Ellis Medicine (Schenectady, NY)
- …and/or linkage to community resources, medical insurance coverage - Medicaid, managed care /dual-eligible parameters; etc. + Actively assists and facilitates ... and external agencies to provide smooth, timely transition of care across the continuum. Activities will be documented as...clinical assessments: Empowers patient to be actively involved in care planning and teaching needs of patient and family… more
- Mount Sinai Health System (New York, NY)
- …claims internally and with established payers + May work with various Team Leads and/or Managed Care related to rate issues. + Works required TRAC billing and ... We share a common dedication to delivering outstanding patient care . When you join us, you become part of...respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building… more
- Molina Healthcare (Syracuse, NY)
- …or other related needs. * Participates in the Statewide Advocacy Program for Managed Care including working with the State External Advocate, Enrollment ... to identify trends or problem areas of access and care delivery. Assists enrollees in the grievance process at...providers as needed. * Works in collaboration with the Care Management department to help resolve member issues/concerns, ensure… more
- Centene Corporation (New York, NY)
- …Clinical Psychology or Clinical Social Work. Three years clinical experience in a health care environment; managed care experience desired. NYS RN license & ... in the review and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a… more
- Trinity Health (Syracuse, NY)
- …as they relate to review and ➢ reporting of documentation. ➢ Knowledge of managed care and third-party payer benefits designs and reimbursement ➢ requirements. ➢ ... ➢ One to three years' experience in a health care environment with exposure, preferably to service line of...and brothers. **VISION:** To be world-renowned for passionate patient care and outstanding clinical outcomes. **CORE VALUES:** In the… more
- Centene Corporation (Queens, NY)
- …Bachelor's degree in related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...performance metrics, and identify opportunities for improvement in patient care and clinical practices + Focuses on value-based … more
- Catholic Health Services (Roslyn, NY)
- …in on-going educational activities related to clinical knowledge, professional issues and the managed care environment. Salary Range USD $66.55 - USD $90.00 /Hr. ... performing in Geriatrics, Neurology & Neurosurgery, Orthopedics, and Pulmonology. Nursing care at St. Francis is also nationally recognized, with multiple Magnet… more
- Merck (Albany, NY)
- …of their current practice structure, business model, and key influencers ( Managed Care Organization/payers, employers, state policy), and their patients' ... within their assigned geography. These customers may include health care providers such as physicians, nurses, pharmacists as well...their geography there are a diverse set of health care locations that they will call upon in order… more
- Whitney Young Health Center (Albany, NY)
- …Minimum of 5+ years related experience in a clinical, non-profit, or managed - care organization environment. Extensive knowledge and understanding of health ... while serving as a bridge between the patients and the health care system. SPECIFIC RESPONSIBILITIES: + Health Navigation: Supporting individuals with social needs… more
- Centene Corporation (New York, NY)
- …assigning work and managing performance of staff. Previous experience within a managed care organization and with Medicaid programs is preferred. Experience ... goals and policies to improve quality and cost-effectiveness of care and service for members. + Provide medical expertise...in order to improve the quality and cost of care . + Interface with physicians and other providers in… more