- Northwell Health (Westchester, NY)
- …to various inquiries from participating physicians, network staff, hospital staff, and managed care companies. + Resolves issues related to credentialing, ... managed care participation, claims payment, demographic changes, referrals, and accessibility....assist providers with the completion of applications for network contract offerings; monitors applications and follows-up as needed. +… 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
- Mount Sinai Health System (New York, NY)
- …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or ... performance to inform our clinical or contracting staff to improve contract outcomes. 2. Care Management - Helps to identify, understand and prioritize at-risk… more
- Highmark Health (Albany, NY)
- …Doctor of Pharmacy degree + Active pharmacist license + 4 years of experience in managed care pharmacy + 2 years of clinical account management experience in ... respective client portfolio as well as its P&L and contract compliance. Responsibilities include leading initiatives regarding the specific...Medicare as part of the 4 year managed care experience + 2 years of… more
- Sedgwick (Albany, NY)
- …Services Director **PRIMARY PURPOSE** : To determine account management strategies related to managed care client service plans; to be responsible for retention ... customer satisfaction, revenue growth, client surveys, and new business; to provide managed care program management for jumbo clients requiring dedicated staff,… more
- Molina Healthcare (Rochester, NY)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and… more
- New York State Civil Service (Albany, NY)
- …analytics models and reimbursement rate methodologies for CDPAS providers and managed care plans; Prepare briefing materials-PowerPoints, policy memos, data ... administration of progressively responsible experience in Medicaid policy, program implementation, or managed care operations; OR a bachelor's degree and five… more
- Catholic Health Services (Rockville Centre, NY)
- …The ideal candidate possesses in-depth knowledge of Medicare/Medicaid reimbursement, managed care contracts, and healthcare finance. Key Responsibilities: ... related to changes in volume, case mix, or payer mix. + Partner with managed care , revenue accounting/reporting, and revenue cycle teams to evaluate payer… more
- Valor Health (Lockport, NY)
- … care . + Acts as point person within PACT Team. + Assists in co- managed care collaboration with non-VA providers, and facilities. + Provides patient and ... local VA medical centers. Our comprehensive set of services includes primary care , diagnostics, laboratory, telehealth, behavioral health, and more. As a Registered… more
- GMHC (New York, NY)
- …communication, program integrity, and compliance with all regulatory and contract requirements. The Managing Director supports a diverse and expanding ... and SURE Housing program. These programs are integrated with case- managed services, financial coaching, behavioral health supports, and community partnerships… more
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