- Humana (Albany, NY)
- …Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization. **Additional Information** **Work Schedule:** + ... policies and procedures ensuring best and most appropriate treatment, care or services for members. UM Administration Coordinator 2...and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana,… more
- America's Best (Newburgh, NY)
- …phone calls in accordance with National Vision protocol. + Processes and understands managed care plans while obtaining document information from the insurance ... parts of the optical equation - eyewear and eye care - into one excellent experience at a single...their best. We help people by making quality eye care and eyewear more affordable and accessible. As the… more
- Humana (Albany, NY)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. The Home Solutions UM Team is hiring for… more
- Catholic Health Services (Hauppauge, NY)
- …licensure in the state of NY. One-year experience in home infusion, hospital or managed care setting preferred. IV clinical experience preferred. Skill in use of ... and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network… more
- Independent Health (Buffalo, NY)
- …customer service when responding to customer requests. + Utilize up-to-date knowledge of managed care criteria to meet department of health standards. + Escalate ... The Provider Relations Representative will answer incoming calls from health care providers including physician offices, ancillary provider offices and facilities… more
- Molina Healthcare (Albany, NY)
- …preferred. **Required Experience** + 3-5 years clinical nursing experience, with 1-3 years Managed Care Experience in the specific programs supported by the plan ... of service provided, length of stay and level of care . + Applies appropriate criteria on PAR and Non-PAR...& Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases in conjunction… more
- Trinity Health (Schenectady, NY)
- …and computer use + Excellent assessment skills and knowledge of insurance and managed care principles and practices + Ability to function independently + ... and other interdisciplinary team members involved in the client's care . If the client is unable to participate in...catastrophically ill or injured individuals or in an acute care hospital required + Acute Rehab knowledge is a… more
- Catholic Health Services (Freeport, NY)
- …in all necessary activities to insure payment for treatment services by insurance/ managed care companies. Maintains statistical data and prepares any necessary ... Join us and Long Live Long Island where we care for Every Patient, Every Time. Explore a career...Breast Imaging Center of Excellence, Level III Neonatal Intensive Care Unit, and has received Pathway to Excellence designation… more
- Cardinal Health (Albany, NY)
- …long and short-range changes in the reimbursement environment including Medicare, Medicaid, Managed Care , and Commercial medical and pharmacy plans while ... (TM) Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy… more
- City of New York (New York, NY)
- …of Persons with Developmental Disabilities (OPWDD, community health, mental health, and managed care organizations around behavioral health services at DHS}. - ... of succeeding in permanent housing and independent living, improving access to care and health outcomes for low-income and vulnerable populations. The Office brings… more