- City of New York (New York, NY)
- …system for individuals with intellectual and/or developmental disabilities, including Medicaid managed care , value-based payment, and program models - Track ... work independently. - Familiarity with health insurance policy, including Medicaid and managed care principles. - Strong research, analytical, oral, writing and… more
- Molina Healthcare (Rochester, NY)
- …+ Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake and interpretation...4 years of experience in previous roles in a managed care organization, health insurance or directly… more
- NYU Rory Meyers College of Nursing (New York, NY)
- …identifying contractual variances between posted and expected reimbursement for Article 28, Managed Care , Commercial Insurance and other payers. Analyze, audit ... and experience. Required Skills, Knowledge and Abilities: Knowledge of guidelines of managed care and claims guidelines and ability to identify trends/issues… more
- Evolent (Albany, NY)
- …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... teams in developing the strategic approach for innovative and in-demand value-based care pursuits. + Support the development of capitated risk partnerships,… more
- American Red Cross (NY)
- …life's work with an ongoing mission that's bigger than all of us. As you care for others, you're cared for with competitive compensation and benefits. You join a ... data sets, industry benchmarks, and market trends to identify patterns, support feasibility assessments, and recommend innovative sourcing and category strategies. +… more
- Highmark Health (Albany, NY)
- …auditing, investigations, regulatory accreditation, process improvement, project management and/or managed care operations **Knowledge, Skills and Abilities** + ... governmental, contractual, and/or corporate entities. Provide consultation and analytic support to assigned functional areas. Continuously monitors regulatory changes,… more
- JPMorgan Chase (New York, NY)
- …of our private equity clients, to enable them to personally co-invest in the funds being managed by their firms. We also use the PLP to offer loans or lines of ... meet employee needs, based on eligibility. These benefits include comprehensive health care coverage, on-site health and wellness centers, a retirement savings plan,… more
- MVP Health Care (Rochester, NY)
- …2 years being ASD related + Utilization or Case Management experience in a managed care organization is preferred + Knowledgeable with diagnosis and procedural ... Applied Behavior Analysis (ABA). This role will also provide care coordination to support members in meeting...+ New York State license required + Licensed Behavior Analyst (LBA) or Board-Certified Behavior Analyst (BCBA)… more
- Elevance Health (Middletown, NY)
- …range of experience with autism services and treatment required. + Prior managed care experience required. **Preferred Skills, Capabilities and Experiences:** + ... use disorder management, a comprehensive employee assistance program, work/life support , specialty programs for autism and depression, and insightful analytics… more
- Capgemini (NY)
- …Space RU127 New York, NY **Travel:** 25% **Job description:** MDR SOC Supervisor/L3 Analyst In the SOC Supervisor role, you'll be entrusted to deliver managed ... interfacing directly with our clients. **Key Responsibilities:** OPERATIONAL RESPONSIBILITIES: Support with investigations from any/all monitoring platforms as they… more