- Molina Healthcare (Rochester, NY)
- **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, ... claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. + This role is involved in… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Provider Data Management and Credentialing Specialist is responsible for ensuring the data integrity for contracted providers. This includes ... ongoing audit of the provider database, monitoring provider sanctions from regulatory agencies, participation status with payer programs, and other demographic… more
- Elevance Health (Latham, NY)
- …is not eligible for employment based sponsorship. **Develops the provider network through contract negotiations, relationship development, and servicing. Primary ... and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard… more
- Hudson Headwaters Health Network (Queensbury, NY)
- If you are interested in provider opportunities with Hudson Headwaters Health Network, Please also send your CV to Jenny Leszyk at ###@hhhn.org HHHN Mission To ... provide the best health care, and access to that...APC's. + All providers are expected to maintain authorized provider status with the Workers Compensation Board. + Consults… more
- Catholic Health Services (Rockville Centre, NY)
- …The Mercy Cancer Institute incorporates the latest technology in cancer care to provide an ideal and comfortable setting for the diagnosis and treatment of cancer. ... Job Details ADVANCED PRACTICE PROVIDER CANCER INSTITUTE SUMMARY: + Our hospital-based Infusion Center...consult offices. The Cancer Institute at Mercy Hospital will provide patients with comprehensive care focused around the patient… more
- Centene Corporation (Queens, NY)
- …perspective on workplace flexibility. **Position Purpose:** Oversee the Provider Relations department including negotiations and administering organization policies ... to build a strong, adaptable team for the future. + Experience with provider performance in cost of care, value-based care, trend analysis, and quality improvement… more
- Molina Healthcare (Syracuse, NY)
- …marketable providers. **KNOWLEDGE/SKILLS/ABILITIES** + In conjunction with Director/Manager Provider Contracts, negotiates high priority physician group and facility ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets and… more
- Molina Healthcare (Buffalo, NY)
- …**Job Summary** Responsible for accurate and timely measurement of critical provider analytics including Network Adequacy and other critical metrics. Synchronizes ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data on ...Provider Network across the enterprise. Validate data on provider databases and ensure adherence to business, system and… more
- All About Kids (NY)
- **Click Here To Refer a Provider - Earn up to $300!** + NY, US + + + + + + To refer a provider please click "Apply to Position" and fill out the information of ... person being referred directly under "Personal Details"ALL ABOUT KIDS PROVIDER REFERRAL PROGRAM All About Kids is proud to...PROGRAM All About Kids is proud to offer a provider referral program. Refer an independent contractor (IC) … more
- Highmark Health (Buffalo, NY)
- …work with the other members of the value-based reimbursement team, provider relations, senior markets, analytics, actuary and key internal/external stake holders ... to provide the most appropriate support for providers with gain/risk...individualized strategic plans to ensure significant cost savings for provider contract holders using innovative continuous improvement methodologies. This… more
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