- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500183 Health Insurance Counseling Work Shift: UR - Day (United States of America) ... and quality functions through high-cost reporting, work queues, and case review . + Maintains departmental standards through quality assurance monitoring. +… more
- CVS Health (New York, NY)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...external vendors. + Oversee delivery of services, such as home care, adult day care, and other long-term care… more
- CenterWell (Albany, NY)
- …largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is ... part of our caring community and help us put health first** The Lead - Medicaid Customer Success oversees...performance and proactively bring issues to the forefront for review + Support new business implementations with a goal… more
- The Institute for Family Health (New York, NY)
- CERTIFIED DIABETES EDUCATOR Job Details Job Location Family Health Center of Harlem - New York, NY Position Type Full Time Education Level 4 Year Degree Salary Range ... - $100000.00 Salary Travel Percentage Negligible Job Shift Day Job Category Health Care Description SUMMARY: The Certified Diabetes Care and Education Specialist, in… more
- Humana (Albany, NY)
- …quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. ... insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization,… more
- Molina Healthcare (Yonkers, NY)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... as needed or equivalent experience (such as specialties in: surgical, Ob/Gyn, home health , pharmacy, etc.). + Experience demonstrating knowledge of ICD-9,… more
- Community Housing Innovations (Fishkill, NY)
- …and review all required pre-closing documents: mortgage loan commitment, home inspection report, HUD Planner's scope of work, 1003, purchase contract, title ... families and individuals live in quality housing, have a home of their own, and a job to support...Paid time off + Personal and Sick Days + Health insurance and health reimbursement account +… more
- FlexStaff (New York, NY)
- …five (5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance, or discharge ... home visits. Utilizes Lenavi analyzer during either the review process and/or assessment. Documents all interactions and outcomes...planning (preferably within a managed care, home care, or community health organization). Proficiency… more
- Guthrie (Binghamton, NY)
- …(5) years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtain ... other members of the Guthrie Healthcare System Enterprise and community resources, including home health agencies, DME companies, nursing homes, etc., to explore… more
- UHS (Johnson City, NY)
- …in billing and clerical work + Previous experience in data processing + Certified home care and/or utilization review work experience Why You'll Love ... Position OverviewUnited Health Services (UHS) is seeking a detail-oriented and...skills and a thorough understanding of insurance requirements. You'll review clinical documentation to confirm it meets agency and… more