- 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
- Mount Sinai Health System (New York, NY)
- …+ Opportunity to work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is responsible for the negotiation, ... related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more
- Mount Sinai Health System (New York, NY)
- …clinical, contracting, finance, IT, analytics, operations, and product development expertise. The Managed Care Contracting Team within MSHP is responsible for ... related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more
- Mount Sinai Health System (New York, NY)
- …and EHR systems. + Organizes routine meetings with health system business leaders and managed care to review payer issues and denials. + Builds effective, ... relationships with key stakeholders across departments (eg, DTP, Human Resources, Managed Care , Finance, and clinical departments) + Collaborates with… more
- Mount Sinai Health System (New York, NY)
- …timely charge capture. + Organizes routine meetings with health system business leaders and managed care to review charge and revenue capture and performance. + ... relationships with key stakeholders across departments (eg, DTP, Human Performance, Managed Care , Finance, and clinical departments) + Collaborates with… more
- Grifols Shared Services North America, Inc (Albany, NY)
- …contract strategy, and represent needs of the customer. *Remain cognizant of managed care coverage throughout the business territory including major accounts ... approach to respond to business customers. The SSR will liaise with Marketing, Managed Markets, Operations, CL&D, Medical Affairs and Telesales to achieve the goals… more
- UHS (Binghamton, NY)
- …Health Services (UHS) is seeking a detail-oriented Contract Technician to join our Managed Care Contracting team. In this role, you will review and ... care is delivered. Primary Department, Division, or Unit: UHS Managed Care Contracting Primary Work Shift: Day Regular Scheduled Weekly Hours: 40… more
- Mohawk Valley Health System (Utica, NY)
- …seeking and obtaining sufficient information/education necessary to function effectively in the managed long term care setting. + Participates in departmental ... Registered Nurse - Care manager - Full Time - Days Department: CARE MGMT SVCS Job Summary The Care Manager is responsible for completing a comprehensive… more
- Mohawk Valley Health System (Utica, NY)
- …related issues. Communicates with members and their families regarding information about Managed Long Term Care (MLTC) services. Provides summary reports, ... Care Navigator - Full Time - Days Department: CARE MANAGEMENT SERVICES Job Summary The Care Managment Navigator provides support to the Care Managers and… more
- Molina Healthcare (Syracuse, NY)
- …requests from outside agencies. **Required Qualifications** * At least 2 years of managed care experience in a call center, appeals, and/or claims environment, ... program(s) proficiency. **Preferred Qualifications** * Customer/provider experience in a managed care organization (Medicaid, Medicare, Marketplace and/or other… more