- Cognizant (Albany, NY)
- …United States. Regardless of your working arrangement, we are here to support a healthy work-life balance though our various wellbeing programs. **Location:** Remote ... is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate adjudication of… more
- University of Rochester (Albany, NY)
- …but not limited to, The Joint Commission TJC, Center for Medicaid and Medicare Services (CMS), National Committee for Quality Assurance (NCQA), State Department of ... utilization of resources. Develops and implements tools and policies to support knowledge management, record keeping, and internal and external communication.… more
- New York State Civil Service (Queens Village, NY)
- …team.* Complete incident reporting and conduct investigations. *Evaluate rehabilitation and support needs of assigned clients on an ongoing basis.* Document findings ... to work on the Family Care Unit as a Home Liaison/ Certification Specialist . Duties include but not limited:*Supervise and monitor the work performance of Home… more
- New York State Civil Service (NY)
- …psychological evaluations or completing functional behavior assessments; developing behavior support plans or writing psychological treatment plans; and/or providing ... utilization review, guidance counseling, pastoral counseling, or as a habilitation specialist or instructor of psychology. A practicum, externship, or clinical… more
- Mohawk Valley Health System (Utica, NY)
- …education (eg, Hospital Incident Command System). + Serve as the facility specialist on alert and notification systems and procedures. + Coordinate the use ... Provide warnings and emergency data to the organization, and operations/technical support to leadership before, during, and after emergencies that affect it.… more
- Grifols Shared Services North America, Inc (Albany, NY)
- …a given geography(territory) the SSR will need to work cross functionally to support demand for our portfolio and ensure appropriate communication to all stakeholder ... the business territory including major accounts and large players (ie, Commercial, Medicare , and Medicaid) *Understanding of Hospital formulary with guidance of RSD… more
- Humana (Albany, NY)
- …the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA Execution, you'll play a hands-on role in translating strategy into real-time ... its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage… more
- Molina Healthcare (Albany, NY)
- …plan such as Utilization Review, Medical Claims Review, Long Term Service and Support , or other specific program experience as needed or equivalent experience (such ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
- New York State Civil Service (NY)
- …for chemical dependency;Or3. current credentials as a Certified Therapeutic Recreation Specialist (CTRS) issued by the National Council for Therapeutic Recreation ... and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining… more
- WMCHealth (Valhalla, NY)
- …NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Clerical/Administrative Support Department: Revenue Integrity Union: No Position: Full Time ... + Researches technical guidance in UB-92 Editor, CPT/HCPCs Guide, CMS website, Medicare Manuals, etc. to resolve billing issues and promote regulatory compliance. +… more