- Evolent (Albany, NY)
- …professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care , or related healthcare consulting entity + Extensive ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Centene Corporation (Queens, NY)
- …Bachelor's degree in related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, ... relations to ensure delivery of the highest level of care to our members. Engage with providers to align...claims, contracting utilization management, or clinical operations. Project management experience… more
- Humana (Albany, NY)
- …Deep understanding and experience with healthcare policies and operations in a managed care setting Excellent oral and written communications skills, including ... and partnering across the enterprise (eg, with Clinical Operations, Markets, Care Management, Analytics, Pharmacy, etc.) to develop discrete, high-value strategies… more
- Centene Corporation (Queens, NY)
- …Administration, related field or equivalent experience. 7+ years of provider relations or contracting experience in a managed care or insurance environment, ... for the future. + Experience with provider performance in cost of care , value-based care , trend analysis, and quality improvement is highly desired. + Develop,… more
- Humana (Albany, NY)
- …in a management field + Prior healthcare industry experience, preferably in the managed care or provider sector **Additional Information** The role reports to ... membership acquisition strategy, identifying key go-to-market priorities, developing new contracting models for value-based care providers, evolving key… more
- WTW (New York, NY)
- …the delivery of global sales enablement processes. + Provide support to managed accounts by partnering with Lead Relationship Managers. + Proactively analyze data ... of Excellence to support the execution of sales activities such as contracting , client intake and questionnaires and proposal support, client satisfaction and sales… more
- CS Energy (Syracuse, NY)
- …and adjust resources. + Assist PM in procurement process, scoping, and contracting of subcontractors and vendors. + Responsible for management of subcontractors and ... experience, with progressively greater responsibility + Successfully led and managed complex project or portfolios valued at $5+ million...Program + Access to FSA - Health & Dependent Care + Access to Short Term Disability + Employer… more
- Northwell Health (New York, NY)
- …Experience: + Eight or more years of insurance experience within a healthcare or managed care setting (preferred) + Claims adjudication experience + Knowledge of ... enrollment & billing + Knowledge of Utilization Authorizations + Knowledge of Provider Contracting + Knowledge of CPTs, ICD 9/ICD 10, HCPC, DRG, Revenue, RBRVS +… more
- Molina Healthcare (Rochester, NY)
- …supervisory/management experience with appeals/grievance and/or claims processing within a managed care setting. **Preferred Education** Bachelor's degree ... with local Health Plan requirements * Works with Claims, Configuration, Contracting , Provider Data Management, and other business partners to resolve provider… more