- Molina Healthcare (Buffalo, NY)
- …* Provides second level behavioral health clinical reviews, peer reviews and appeals . * Supports behavioral health committees for quality compliance. * Implements ... (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other… more
- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and ... to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials and … more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Garnet Health (Middletown, NY)
- …for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and ... Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible… more
- Helio Health Inc. (Syracuse, NY)
- …when a question or concern arises. + Communicates insurance trends and unresolved appeals to the billing manager for further action. + Demonstrates adaptability ... files necessary for research and documentation. + Researches open claims and processes appeals when necessary. Follows up on patient and insurance company issues in… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case management for an assigned ... care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a minimum of...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as… more
- EAC Network (Garden City, NY)
- …Category Human Service Description Join Our Team as a Grants and Development Manager ! Are you passionate about supporting diverse populations and making a real ... Long Island and NYC, is looking for a dedicated full time Grants and Development Manager to join the Development team here at EAC Network. + Salary: $75,000 to… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager (Inpatient) Mount Sinai Morningside FT Days EOW** The Case Manager (CM) will be responsible for all aspects of case ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals 15. Communicates clinical information to the payor, as… more
- MVP Health Care (Rochester, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Case Manager , Medicaid Long Term Support Program** to join #TeamMVP. If you have a ... complex Medicaid members. + Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of...maintain cost-effectiveness and manage Medical Loss Ratio (MLR). + Appeals & Denials: Participate in the appeals … more
- Calvary Hospital (Bronx, NY)
- The RN Case Manager (RNCM) will be responsible for all aspects of case management for an assigned group of patients to determine the appropriateness of the Level of ... collaboratively with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as needed, coordinating… more
