- Cardinal Health (Albany, NY)
- …OH. The _Director of Business Development, Market Access_ is a seasoned managed care executive and strategic individual contributor responsible for developing ... contract lifecycle. + Serve as the external subject matter expert on managed care , value-based payment methodologies, and population health trends, leveraging… more
- Molina Healthcare (Yonkers, NY)
- …+ 2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare ... discuss and resolve issues related to utilization management, pharmacy, quality of care , and correct coding, for example. + Independently delivers training and… more
- Molina Healthcare (Syracuse, NY)
- …eligible recipients for enrollment into Government Programs such as Medicaid/Medicaid Managed Care , Child Health Plus and Essential Plan. Additionally, ... in selection of the appropriate health plan. The Enroller provides information on managed care programs and how to access care . The MFE is responsible… more
- Trinity Health (Troy, NY)
- …via computer. Pre-authorization and case management is done with reviewers at the Managed Care Organization that is responsible for approving a client's ... those determinations are made, presenting the clinical cases to insurers and managed care companies to secure authorizations for admission to treatment at the… 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
- 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
- Humana (Albany, NY)
- …services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed ... The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments… 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