- Humana (Albany, NY)
- …(EAPG, APR-DRG, MS-DRG, etc). This role is within the Integrated Network Payment Solutions (INPS) department which falls under the Provider Process and Network ... and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior...compliance + Determining root causes driving issues and developing solutions + Working closely with IT and pricing software… more
- Evolent (Albany, NY)
- …SOUTHWEST REGION We are seeking a strategic and collaborative Associate Director, Provider Engagement to lead our oncology-focused provider engagement and ... practice transformation efforts in the **New Mexico** . Reporting to the National Provider Engagement Sr. Director, you will be responsible for building and managing… more
- Molina Healthcare (Cheektowaga, NY)
- …- CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, ... County, NY _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and … more
- Vatica Health (Scarsdale, NY)
- The Provider Engagement Manager (PEM I), is an integral role at Vatica, responsible for overall practice success, including but not limited to provider ... Through cross-functional collaboration, the PEM I is responsible for improving provider satisfaction, quality and risk adjustment performance in the Vatica Health… more
- Molina Healthcare (New York, NY)
- …understands solutions required to improve health outcomes. * Drives provider participation in Molina risk adjustment and quality efforts (eg Supplemental data, ... **Job Description** **Job Summary** The Provider Engagement Manager implements Health Plan provider...The Provider Engagement Manager implements Health Plan provider engagement strategy to achieve positive quality and risk… more
- Molina Healthcare (NY)
- …Description** **Job Summary** Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains ... critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they… more
- CVS Health (Albany, NY)
- …are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital ... Vale Based Care (VBC) National Specialty network strategies, monitors provider performance metrics, leads dispute resolution processes, and collaborates with… more
- Mount Sinai Health System (Astoria, NY)
- **Job Description** ** Provider Enrollment Analyst-Billing-Full Time-Day-Mount Sinai Queens** The Provider Enrollment Analyst (I) is responsible for completion of ... all provider insurance credentialing and re-credentialing functions, including meeting requirements...labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such… more
- Molina Healthcare (Buffalo, NY)
- …DESCRIPTION Job Summary Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim ... documents all calls and interaction Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates… more
- Molina Healthcare (Syracuse, NY)
- …**Job Summary** Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim ... claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. + This role is involved in… more