- New York State Civil Service (New York, NY)
- …billing patterns and troubleshooting reimbursement practices that are inconsistent with model managed care contract . * Supervise staff, including time ... limited to the following:* Provide direct management and oversight of the Medicaid Managed Care Behavioral Health plan audits, including desk reviews, written… more
- Regeneron Pharmaceuticals (New York, NY)
- …history of high sales performance + Experience with reimbursement programs, government programs, managed care , formulary and contract negotiation To be ... **Medical Specialist , Diabetic Eye - Albany, NY** Known for...day might include the following:** The Diabetic Eye Medical Specialist will report to the Regional Director and will… more
- WM (Buffalo, NY)
- …a safe, responsible, and sustainable way. **Position Purpose:** The Healthcare Specialist is responsible for providing strategic guidance towards the compliant, safe ... of the regulations associated with the waste streams being managed (ie, EPA, DOT, DEA, and any other state...customized training for the implementation and maintenance of the contract + Regularly schedule and complete customer-facing activity with… more
- Molina Healthcare (Syracuse, NY)
- …diploma or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and ... Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.… more
- Molina Healthcare (Buffalo, NY)
- …High School Diploma or equivalency **REQUIRED EXPERIENCE:** + Min. 2 years operational managed care experience (call center, appeals or claims environment). + ... Responsible for meeting production standards set by the department. + Apply contract language, benefits, and review of covered services + Responsible for contacting… more
- Molina Healthcare (Syracuse, NY)
- …ensure effective and efficient business results. * Trains and monitors newly hired Contract Specialist (s). * Participates with the management team and other ... field including, but not limited to, provider's office, managed care , or other health care...multispecialty provider groups. * 3+ years experience in provider contract negotiations in a managed healthcare setting… 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
- Independent Health (Buffalo, NY)
- …required. Utilization Management experience preferred. + Comprehensive knowledge and experience with managed care benefit plans. + Ability to research and assist ... accordance with regulatory standards, clinical criteria, and member benefit contract . **Qualifications** + Registered Nurse (RN) with active, current, unrestricted… 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
- Catholic Health Services (Melville, NY)
- …insurance eligibility and pre- certification systems. + Must have expertise in insurance, managed care and federal/ state coverage. + Must be customer focused ... and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network… more