- Evolent (Albany, NY)
- …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... sales with long cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers and risk-bearing organizations)… more
- Molina Healthcare (Yonkers, NY)
- …investigative and law enforcement procedures with emphasis on fraud investigations. + Knowledge of Managed Care and the Medicaid and Medicare programs as well as ... investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. Duties include performing accurate and reliable… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and working knowledge of Utilization Management Standards. + Experience in interpreting managed care benefit plans and strong knowledge of government program ... of clinical knowledge, members' specific health plan benefits, and efficient care delivery processes. Ensures compliance with corporate and departmental policy and… more
- Valor Health (Ithaca, 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
- Rochester Regional Health (Rochester, NY)
- …+ 2 years of pharmacy technician experience in a retail/community pharmacy or managed care setting EDUCATION: LICENSES / CERTIFICATIONS: PHYSICAL REQUIREMENTS: S ... positive outcomes + Employer contract initiatives: Participation in employer contract specific initiatives in collaboration with the care management team… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and working knowledge of Utilization Management Standards. + Experience in interpreting managed care benefit plans and strong knowledge of government program ... of clinical knowledge, members' specific health plan benefits, and efficient care delivery processes. Ensures compliance with corporate and departmental policy and… more
- Molina Healthcare (Buffalo, NY)
- …root causes of payment errors. **Required Qualifications** * At least 2 years of managed care experience in a call center, appeals, and/or claims environment, or ... 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)
- …cycle, including pre-award budget development, post-award monitoring, program sub- contract management, and grant closeout procedures. Provides technical assistance ... guidance in the preparation, submission, processing and management of research grants, contract proposals, awards and all agreements for Research teams within the… more
- The Cigna Group (New York, NY)
- …relationships with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with ... impact of larger or complex provider contracts and alternate contract terms. + Creates "HCP" agreements that meet internal...of life. We guide our customers through the health care system, empowering them with the information and insight… more
- Highmark Health (Albany, NY)
- …Consulting or related area + 3 years Value-based reimbursement, through managed care contracting, provider reimbursement, consulting, population health delivery ... and maintains strategic provider relationships to understand the current health care delivery state, readiness for change, test value based programming concepts… more