- University of Rochester (Rochester, NY)
- …trends of incorrectly paid claims from specific payers - - Work with supervisor/ manager on communication to payer representatives regarding payment trends and ... specialized services. Revenue Collection activities focus on an assigned payer billed at the primary level. Schedule 7:30 AM-4...tasks, following standard procedures, and as directed by the Manager , Billing or Manager . Independent judgement is… more
- Albany Medical Center (Albany, NY)
- … terms. The Director is skilled at drafting, analyzing, and negotiating complex payer contracts . The Director develops contract proposals and leads ... and builds systems and standardized processes to facilitate multi-stakeholder collaboration on payer contracts to achieve best negotiation outcomes. + Develops… more
- WMCHealth (Poughkeepsie, NY)
- …Schedules monthly meetings with Manager of Contracts to report payer trending analysis. Incorporates Contract Management and Denial Management staff as ... analysis on payer trending and reports findings to the Contract Manager and Director of Patient Financial Services, actively participates in discussions and… more
- Cardinal Health (Albany, NY)
- …contracting, enrollment, credentialing, and any other activity as it relates to payer interaction. Manager of Payor Contracting is responsible for reviewing, ... payer market. Key member of negotiating team for company. + Negotiates contract language across all contracts , striving for uniformity among different … more
- Sumitomo Pharma (Albany, NY)
- …dynamic, highly motivated, and experienced individual for the position of Sr. Manager , Medicaid Contract Administration. This position is responsible for ... of the life science industry specific to the Medicaid payer landscape. The decisions made in this position affect...Compliance, and Legal) to clarify policy compliance requirements and contract language clauses. + Keep current on regulatory and… more
- Northwell Health (Staten Island, NY)
- **Req Number** 162425 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient ... clinical course + Ensures compliance with current state, federal, and third party payer regulations + Documents the case management process in the medical record;… more
- Mount Sinai Health System (New York, NY)
- …Develops and maintains standard contract compliance analyses of MSHP IPA negotiated contracts utilizing contract manager and other data sources. 4. ... experience in a hospital/healthcare environment is required. Advanced knowledge of Epic, Contract Manager , and Microsoft Excel Working knowledge of other… more
- Guthrie (Binghamton, NY)
- Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal patient, clinical, and operational outcomes timely, coordinated, ... and in cost effective manners. The Acute Case Manager has the responsibility, accountability, and authority for coordinating the medical management of hospital… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …Specialty Pharmacy Operations We are seeking a detail-oriented and proactive Senior Manager of Pharmacy Operations to support the operational execution of our new ... operations, and addressing any operational issues that arise. The Senior Manager will also collaborate closely with Account Managers, Field Reimbursement Managers,… more
- Northwell Health (Staten Island, NY)
- …to the health care team regarding quality, utilization of clinical resources, payer , and reimbursement issues. + Works with on-site screeners in transitioning ... clinical course. + Ensures compliance with current state, federal, and third party payer regulations. + Identifies patients for Alternate Level Care (ALC) care list… more
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