- Molina Healthcare (Syracuse, NY)
- …an integrated delivery of care across the continuum, including behavioral health and long -term care, for members with high need potential. HCS staff work to ensure ... that involve clinical HCS staff. Communicates findings to the Supervisor or Manager , HCS Department for resolution. + Maintains a minimal caseload as determined… more
- Catholic Health Services (Melville, NY)
- Overview Catholic Health is one of Long Island's finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, ... (UR), discharge planning (DP), LOC and clinical documentation. Works with Corporate Compliance to interpret new regulatory and compliance requirements and… more
- Molina Healthcare (Yonkers, NY)
- …**Highly Qualified Candidates Will Have the Following Experience-** Digital Tag Manager Programs Salesforce Marketing Cloud Google or Adobe analytics (or similar) ... Google AdWords, Tag Manager systems, (Adobe or Google) CMS (content management system)...utilizing best practices to increase lead conversion + Ensure compliance with consumer protection laws (CAN-SPAM, TCPA, etc.) and… more
- Humana (Albany, NY)
- …comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root causes driving issues and developing solutions + ... researching and resolving provider reimbursement inquiries + Experience with Optum Rate Manager + Experience with Optum WebStrat or PSI applications + Experience… more
- Humana (Albany, NY)
- …campus and datacenters. The primary responsibility of the Network Operations Manager will be to provide the highest quality network infrastructure environment ... for future budget forecasting and planning needs. + Communicate status updates to Manager of IT and other Senior business leaders where necessary. + Research and… more
- Humana (Albany, NY)
- …with our Security Automation Product Owner, Product Security Product Manager , Product Security Governance, DevOps, Enterprise Information Protection and Enterprise ... Information Systems Security Professional * (CISSP), Certified Information Security Manager (CISM), Certified Information Systems Auditor (CISA) or other similar… more
- Catholic Health (Cheektowaga, NY)
- …of this individual. This individual will have supervisory responsibilities over manager coding and chart auditing services, professional medical coders, auditors and ... and understanding of regulatory guidelines to continuously improve processes and compliance along with managing professional outpatient coding and chart auditing… more
- Humana (Albany, NY)
- …largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical, ... questions on financials and operations + Provide financial insights for long -term strategic decision-making across the broader CW segment + Support prioritization… more
- Molina Healthcare (Albany, NY)
- …appropriate and correct clinical decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) ... on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long -Term Services & Supports issues. + Identifies and reports quality of… more
- Catholic Health Services (West Islip, NY)
- …Coordination department, Medical Staff, and SCSH Administrative Staff. Ensures compliance with Hospital Conditions of Participation. Implements care management ... staff with challenging discharge barriers. Coordinates with post-acute facilities (rehab, long term placement, assisted living, group home) to better support our… more