- Excellus BlueCross BlueShield (Buffalo, NY)
- …and peer-to-peer calls in timely manner and provides support for the Case Management (CM) and Registered Nurse (RN) reviewers and manages the denial process. + ... Leads interdisciplinary complex care management rounds. + Provision of clinical oversight and leadership...with Provider Relations staff to ensure an adequate provider network via required provider credentialing guidelines. + Participates in… more
- Amazon (New York, NY)
- …North America. This executive role combines technical leadership with program management , requiring you to drive the regional strategy while ensuring excellence ... efficiency - Oversee day-to-day operations, including both technical practices and program management - Drive risk management and stakeholder engagement to… more
- Centene Corporation (New York, NY)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... in absence of VPMA. + Provide medical leadership for all utilization management , pharmacy, case management , disease management , cost containment,… more
- Highmark Health (Albany, NY)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external audit findings and responds as… more
- Datavant (Albany, NY)
- …the right format. Our platform is powered by the largest, most diverse health data network in the US, enabling data to be secure, accessible and usable to inform ... combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be accountable for ensuring our products deliver… more
- Empire State University (NY)
- …+ Business Analytics (Data Models and Structured Analysis, Data Mining, Applied Management Analytics) + Finance (Strategic Cost Analysis, Mergers and Acquisitions) + ... Healthcare Management (Health Information Management and Informatics, Delivery, Legal and Regulatory Affairs) + Human Resources (Strategic, International, Labor… more
- Citizens (New York, NY)
- …suggestion for remediation and to identify opportunities to improve risk management processes and procedures through automation and or Artificial Intelligence (AI). ... and strategies. Key Skills and Qualifications: + Strong Knowledge of Risk Management Principles: A solid understanding of various risk types (eg, operational,… more
- WSP USA (New York, NY)
- **VP or Director Tolling/ITS, Project Management -** We are seeking an experienced and highly motivated Project Manager to join our team in Southern California. This ... and contribute to ITS projects focusing on: + Traffic management systems. + Corridor management technologies and...+ Data governance and analytics within transportation systems. + Network security and standards best practices. + Review and… more
- University of Rochester (Rochester, NY)
- …in Ambulatory/Outpatient Pharmacy to include business development, operations management , clinical services, pharmacy data analytics, and pharmacy ... procurement/inventory management . The Senior Director, Ambulatory Pharmacy Services in concert...to meet the patient needs evolving from a growing network of providers under regional healthcare reform efforts of… more
- ICON Clinical Research (New York, NY)
- …matters regarding ICON Laboratory Services (ILS), including the setup and day-to-day management of studies, attend and represent ILS at Client meetings, manage ... documents are archived at study closure. + Provide Sponsors with study management reports. Provide client with support on ICOLabs system. Inform team leader… more