- Humana (Albany, NY)
- …MPH, or other relevant advanced degree + Healthcare industry experience, particularly in managed care or provider sectors + Experience leading strategy projects ... other health plans to millions. By integrating insurance with care delivery through CenterWell, Humana is improving healthcare access,...serve to achieve their best health - delivering the care and service they need, when they need it.… more
- CVS Health (Albany, NY)
- …Medicare, and/or Medicaid knowledge * 5+ years related experience, proven and proficient managed care network negotiating skills. * 3+ years contracting for ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- CDPHP (Latham, NY)
- …related discipline required. + Utilization management experience is preferred. + Knowledge of managed care , health plan benefits, and be able to carefully assess ... a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous...that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee… more
- Centene Corporation (New York, NY)
- …or acute care hospital. Training or auditing experience in a managed care or healthcare setting. **Required License/Certification:** RN, PA, MD, APRN, ... for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care . The Clinical Coding Auditor & Trainer position is primarily remote with a… more
- Family and Children's Association (Mineola, NY)
- …session and telephone calls. + Complete treatment plans in accordance with State and Managed Care Organization Guidelines. + Coordinate with child's Care ... school equivalency with two years' experience in children's mental health, addiction foster care and/or a related human services field. + Valid New York State… more
- Caz Recovery (Buffalo, NY)
- …intake practices to ensure all applicants are pre-approved for financial payments, including congregate care II, SSI, SSD, Managed Care , or other third party ... options to help reduce fear and other attitudes that obstruct acceptance of care and continuation of treatment. + Assesses, coaches, and develops the intake team's… more
- Molina Healthcare (Yonkers, NY)
- …10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization decisions are rendered… more
- Albany Medical Center (Albany, NY)
- …across the continuum of care . + Expertise in entitlement eligibility, managed care , guardianship, immigration and naturalization laws. + Ensures efficient ... requirements. + Assists in the development of policies and procedures, standards of care and practice, and in the monitoring processes in relations to those standard… more
- Molina Healthcare (Yonkers, NY)
- …equivalent combination of education and experience **Required Experience** * 3 years managed care experience, preferably with a national or multi-location ... of business to better support overall population heath management, reduce gaps in care and drive medical loss ratio (MLR) targets. In conjunction with the Manager… more
- Humana (Albany, NY)
- …in a management field + Prior healthcare industry experience, preferably in the managed care or provider sector **Reporting Relationships** The role reports to ... 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