- Mohawk Valley Health System (Utica, NY)
- …and reimbursement models in decision making and reviews. + Provide peer-to-peer payor review in collaboration with attending physicians. + Support Recovery ... Perform concurrent review and escalation of cases not meeting criteria. + Provide guidance and advisory services to physicians, case managers and clinical… more
- Molina Healthcare (Yonkers, NY)
- …(UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS ... from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions… more
- WMCHealth (Valhalla, NY)
- …and concurrent, based on medical necessity criteria. 2. Identify opportunities to improve reimbursement . 3. Provide direction to the Case Management staff in ... of care changes and delays in services that effect reimbursement . + Work closely with Patient Accounting to Improve...insurance vendors. + Acts as a resource person for hospital staff and physicians that result in a reduction… more
- MVP Health Care (Utica, NY)
- …environment, with some experience in the health care industry such as a hospital , medical office, or health insurance company. + An Associate degree or equivalent ... individuals and seamlessly enrolling them in a variety of plans including Medicaid , Child Health Plus, Essential Plan, Qualified Health Plans (QHPs), HARP,… more
- MVP Health Care (Fishkill, NY)
- …sales environment, with some experience in the health care industry such as a hospital , medical office, or health insurance company. + The ability to speak more than ... individuals and seamlessly enrolling them in a variety of plans including Medicaid , Child Health Plus, Essential Plan, Qualified Health Plans (QHPs), HARP,… more
- Mount Sinai Health System (New York, NY)
- …quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. ... to keep entire communities healthy and out of the hospital . Mount Sinai Health Partners (MSHP) is the team...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- WMCHealth (Kingston, NY)
- …review open balances and aged self pay and Medicaid pending accounts. + Provide technical reimbursement research and assist in reimbursement analysis. + ... Patient Account Coordinator Company: HealthAlliance Hospital City/State: Kingston, NY Category: Clerical/Administrative Support Department: Patient Accounting Union:… more
- Sanofi Group (New York, NY)
- …+ Maintain extensive knowledge of the Managed Care, GPOs, Specialty Pharmacy, State Medicaid and Veterans Affairs selling and reimbursement environment for their ... of belumosudil in their assigned geography, if approved. The IHM will provide on-label product information to designated key opinion leaders, health care… more
- Catholic Health Services (West Islip, NY)
- Overview Good Samaritan University Hospital is proud to be recognized as a Magnet(R) facility for excellence in nursing care. Good Samaritan University Hospital ... is a 537- bed (including 100 nursing home beds) teaching hospital and a member of Catholic Health. With almost 900 physicians on staff, and a level I Trauma Center,… more
- Ideal Home Care (Islandia, NY)
- …Must be a registered nurse with a public health, home health care, or hospital background * Must have at least 2 years clinical experience Physical qualifications: * ... the quality of care delivered to the patient E. Provide in home supervision of field staff at least...is a change in the patient condition, after a hospital stay, and a time of discharge revising the… more