- Humana (Albany, NY)
- …**Use your skills to make an impact** **Required Qualifications** + Experience with Utilization Review and/or Prior Authorization within a managed care call ... related field + Prior member service or customer service telephone experience desired **Work-At- Home Requirements** To ensure Home or Hybrid Home /Office… more
- Evolent (Albany, NY)
- …role in **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This is an opportunity for a **Cardiologist** to ... cardiovascular programs that include improvements to clinical effectiveness of utilization management (UM) and risk-based models.** + Process improvement and… more
- Humana (Albany, NY)
- …with medical terminology and/or ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... will be moving forward to next round of interviews. **Work at Home Guidance** To ensure Home or Hybrid Home /Office associates' ability to work effectively,… more
- Humana (Albany, NY)
- …of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at Administrative ... on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health insurance organizations,… more
- Humana (Albany, NY)
- …first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on ... on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health insurance organizations,… more
- City of New York (New York, NY)
- …CYF-DD collaborates with large DOHMH programs, such as: (a) The New Family Home Visits program that offers support, services and referrals to new and expectant ... oversee perinatal mental health data reporting from provider agencies (eg, P+ECMH Network, home visiting, doula services) and use it to inform program outcomes and… more
- FlexStaff (Flushing, NY)
- …religious backgrounds, and congenital or acquired disabilities. JOB RESPONSIBILITIES: - Review and ensure effective development and execution of personalized care ... in attaining and maintaining optimal health status. - Collaborate with clinicians to review UAS and the UAS analyzer system to ensure accuracy of their assessments.… more
- CenterLight Health System (Ridgewood, NY)
- …religious backgrounds, and congenital or acquired disabilities. JOB RESPONSIBILITIES: + Review and ensure effective development and execution of personalized care ... in attaining and maintaining optimal health status. + Collaborate with clinicians to review UAS and the UAS analyzer system to ensure accuracy of their assessments.… more
- FlexStaff (New York, NY)
- …religious backgrounds, and congenital or acquired disabilities. JOB RESPONSIBILITIES: Review and ensure effective development and execution of personalized care ... support in attaining and maintaining optimal health status. Collaborate with clinicians to review UAS and the UAS analyzer system to ensure accuracy of their… more
- City of New York (New York, NY)
- …a timely manner. - Support marketing and outreach activities to increase visibility and utilization of the CI&R system and home visiting programs. - Participate ... this vision by supporting and promoting breast/chest-feeding, infant safety, and home visiting services to pregnant and parenting families. DUTIES WILL INCLUDE… more