- Highmark Health (Buffalo, NY)
- …includes analyzing performance reports and data to inform decision-making, process, and program implementation, as well as the development of process ... result in the greatest ROI for the Organization. Further, in a matrix management environment, will be responsible for collaborative work with the other members of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as required, to ... and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of clinical knowledge,… more
- Molina Healthcare (Albany, NY)
- …and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a ... management , and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/Managed care experience **PREFERRED LICENSE,… more
- Celestica (New York, NY)
- …Attributes** + Executive Relationship Management + Sales Process and Business Development Management + Industry, Market & Technology Knowledge + Operations ... management (issues, projects, escalations, etc.) + New business development (Growth/bookings, RFP/RFQs, P&L analysis, solution development , CRM, etc.)… more
- MTA (New York, NY)
- …award of $2-3 billion in new construction contracts per year and supporting the management of claims and changes on contracts valued at approximately $5 billion. ... Construction Contracts Job ID: 12603 Business Unit: MTA Construction & Development Location: New York, NY, United States Regular/Temporary: Regular Department:… more
- CVS Health (Amherst, NY)
- …setup essential for online viewing and processing related to Customer Service, Claims , Enrollment, Billing and Reporting in support of internal and external ... rate adjustments or renewal activity. + Collaborates on review, analysis and development of recommendations for the design of complex account and benefit structures… more
- CVS Health (Amherst, NY)
- …interpretation, and systematic setup essential to the processing of our claims adjudication system. Meritain's proprietary system provides a benefit solution for ... and systematic setup essential to the processing of our claims adjudication system. The setup must also align for...or renewal activity. + Collaborates on review, analysis, and development of recommendations for the design of complex account… more
- Sunrise Senior Living (Glen Cove, NY)
- …Information Monitoring/Process and Systems, Financial Systems Close and Management , Business Processes-Key Controls, Technical/Professional Knowledge, and Quality ... internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate and… more
- Walgreens (Rochester, NY)
- …Improvement Program . + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with insurance ... and business ethics. + Responsible for the selection, scheduling, and development of pharmacy technician personnel. Leads training, coaching, and performance … more
- AECOM (New York, NY)
- …throughout the project lifecycle - from advisory, planning, design and engineering to program and construction management . AECOM is a Fortune 500 firm that ... & Places **Business Group:** DCS **Strategic Business Unit:** East **Career Area:** Program & Project Management **Work Location Model:** Hybrid **Legal… more