- New York State Civil Service (New York, NY)
- …a hearing request. This includes identifying the appropriate local district location, managed care organization, or State entity.* Fields compliance complaints, ... from the Fair Hearing Information System, Welfare Management System, Automated Child Care Information System, New York City Work Accountability and You, State… more
- Humana (Albany, NY)
- …impact** **Required Qualifications** + 2 - 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. ... for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in Pharmacy is required with a minimum of three (3) years' experience in a managed care setting. Experience in Medicare Part D is strongly preferred. + Expertise ... tasks. + Supports and educates inter-departmental staff (clinicians, customer care , sales) and external customers (members, brokers) with respect to… more
- Access: Supports For Living (Mount Vernon, NY)
- …and able to perform the functions of electronic charting -Knowledge of the managed care authorization process -Ability to be flexible JOB RESPONSIBILITIES + ... Maintain consistent work attendance. + Requests for time off are made to assigned supervisor. + Screen, assess, and evaluate all incoming referrals; provide initial assessment. + Provide individual, group and family therapy, in the office and in community… more
- Actalent (New York, NY)
- …resolve immediate problems, and communicate actions to the Unit Supervisor. Essential Skills + Care management + Managed care + RN license + Graduate ... from an accredited school of nursing + NYS licensure as an RN + Good oral and written communication skills + Good interpersonal skills + 6+ months experience + Case management + Geriatrics + Triage + EMR experience Additional Skills & Qualifications + 6 months… more
- Humana (Albany, NY)
- …degree in a management field + Prior healthcare industry experience, preferably in the managed care or provider sector Travel: While this is a remote position, ... for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a… more
- Molina Healthcare (Syracuse, NY)
- …research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry **PREFERRED EDUCATION:** Bachelor's ... Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 4 years **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office… more
- Health Plus Management LLC (Uniondale, NY)
- …insurance terminology for collecting, local coverage determinations policies, A/R follow-up and managed care regulations Skills & Abilities: + Proficient in the ... that give the physicians and therapists the opportunity to provide patient care without worrying about the administrative needs of the practice. This position… more
- Molina Healthcare (Albany, NY)
- …a clerical role in a claims, and/or customer service setting - preferably in managed care , or equivalent combination of relevant education and experience. + ... and applicable software programs proficiency. **Preferred Qualifications** + Health care claims auditing/billing experience. To all current Molina employees: If… more
- Elevance Health (New Hyde Park, NY)
- …providers in areas with increased competition or where greater provider education around managed care concepts is required. + Working with contracts that may ... for autism and depression, and insightful analytics to improve the delivery of care . **Provider Network Manager - New York** This is an Individual Contributor… more