- Rochester Regional Health (Rochester, NY)
- …hospital with state and federal regulations, and maintain professional standards. The Senior Utilization Review Specialist assists providers with level of care ... determinations in compliance with regulatory and contractual agreements. The Senior Utilization Review Specialist will act as a mentor and resource for… more
- Highmark Health (Buffalo, NY)
- …the other members of the value-based reimbursement team, provider relations, senior markets, analytics, actuary and key internal/external stake holders to provide ... analyzing performance reports and data to inform decision-making, process, and program implementation, as well as the development of process interventions based… more
- New York State Civil Service (New York, NY)
- …for hire under the Hiring for Emergency Limited Placement - Statewide (NY HELPS) program as a Senior Recreation Therapist if they have either:* Bachelor's degree ... NY HELP Yes Agency Mental Health, Office of Title Senior Recreation Therapist, (NY HELPS), Washington Heights Psychiatric Unit, P27086 Occupational Category Health… more
- New York State Civil Service (Staten Island, NY)
- …Therapist, Chief Physical Therapist, Chief Recreation Therapist, Developmental Disabilities Program Specialist 1, Developmental Disabilities Program ... Specialist 1 (Spanish Language), Developmental Disabilities Program Specialist 2, Developmental Specialist 4, Head Occupational Therapist, Head Physical… more
- New York State Civil Service (Tupper Lake, NY)
- …Human Resources Specialist 1, Nutrition Services Administrator 1, Purchasing Agent, Senior Accountant, Senior Auditor, Senior Budgeting Analyst, ... Officer Trainee 1, or Business Officer Trainee 2; Or B. Administrative Specialist 1, Assistant Office Services Manager, Contract Management Specialist 1,… more
- Healthfirst (NY)
- …on Medicaid and other program issues as well as on changes in Medicaid// Medicare //HMO laws and shares information with other Social Work and Care Team members as ... pre-enrollment screening: Meets with individuals who may qualify for enrollment in Senior Health Partners or Montefiore MSO throughout the 5 boroughs, Westchester… more
- Evolent (Albany, NY)
- …+ Not under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid, and is not identified as an "excluded ... Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the… more
- Healthfirst (NY)
- …eligibility, exclusion, and exemption codes. + Searches in Marx (CMS) for Medicare eligibility, enrollments, and special elections. + Achieves daily, weekly, and ... all field and tele video conference appointments for HF CompleteCare Specialist and Intake Nurses in Salesforce. + Schedules Entitlement Advocates appointments… more
- Humana (Albany, NY)
- …Experience Platform (AEP) and Next Best Action (NBA) execution to join the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Our… more
- Rochester Regional Health (Rochester, NY)
- …requirements of third party payors are maintained. Creates departmental reports for senior management. RESPONSIBILITIES + Oversees the review process of third party ... Provides ongoing support for the tracking and trending of the Reimbursement Specialist charge recovery activities. + Assists with special projects including but not… more