- Elevance Health (Latham, NY)
- **Anticipated End Date:** 2024-09-23 **Position Title:** Care Consultant Sr. ( Provider Success) **Job Description:** Care Consultant Sr. (New York ... listed above, at least 1 day per week. The ** Care Consultant Sr.** for ** Provider Success** is...around population health management, patient satisfaction and quality and cost performance. + Facilitation of collaborative meetings with staff… more
- CVS Health (Albany, NY)
- …to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved. + Supports or assists ... design, contract language, service, claims or compensation issues, and provider education needs. + Optimizes interactions with assigned providers and internal… more
- Highmark Health (Albany, NY)
- …meetings, deliverables, resources etc. for individualized strategic plans to ensure significant cost savings for provider contract holders using innovative ... markets, analytics, actuary and key internal/external stake holders to provide the most appropriate support for providers with gain/risk...and workflow across the continuum of variability in primary care and experience in managing provider and… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Health, Department of Title Contract Management Specialist 1/Trainee (NY HELPS) - 63484 Occupational Category Financial, Accounting, Auditing ... an exam to gain permanent competitive status.The position may be filled at the Contract Management Specialist Trainee 1 level equated to SG-13, $49,363, Contract … more
- CVS Health (Albany, NY)
- …will: + Drive the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. + ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Humana (Albany, NY)
- …us put health first** The Delaware Valley ACO (DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' ... the program may include rotations through various DVACO departments including Care Coordination, Practice Transformation, Data Analytics, Post-Acute Care and… more
- Option Care Health (Albany, NY)
- …alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly ... resulting in high quality outcomes at a significantly reduced cost . Option Care Health has more than...treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through… more
- HomeSafe Alliance (Albany, NY)
- …include but not limited to schedule, delivery, performance, quality, safety, cost control, P&L, Service Provider relationships, and customer satisfaction. ... GHC prime contractor and household goods moving service integrator, we provide earlier visibility into upcoming moves and greater network throughput… more
- IMSolutions, LLC (Albany, NY)
- …to work at the agency's office in Washington, DC._** As a **Federal Contract Specialist** , you provide acquisition support services, including contract ... and contract closeouts. + Market research/analysis, selection and administration of contract terms and conditions, cost , and price analysis. + US Citizenship… more
- New York State Civil Service (Albany, NY)
- …identified to needing additional support to be served at an appropriate level of care .* Provide clinical oversight and direction for mental health services for ... limited to the following:* Develop, implement, and monitor behavioral health provider training initiatives including dissemination of provider -facing training… more
- Highmark Health (Albany, NY)
- …configurations and onboarding of new plans/providers. Translates configuration rules, fee schedules, contract terms, provider data code sets, and benefits into ... to benefits, business rules, screen design and functionality, templates, workflows, provider contracts, user task analysis, personalization to different plans, and… more
- Elevance Health (Latham, NY)
- …most complex or elevated medical issues.** **Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of ... member access to medical necessary, quality healthcare in a cost effective setting according to contract +...or any combination of education and experience, which would provide an equivalent background. + Prior managed care… more
- Albany Medical Center (Albany, NY)
- …responsible for supporting system-wide service line reporting, financial analysis and managed care contract valuation and analysis for Albany Med Health System. ... all the contractual terms and rates for our managed care contracts in addition to government payor modeling. They...Provide technical support for service line reporting and contract analysis modules in Strata for AMHS. + Supporting… more
- Elevance Health (Latham, NY)
- …participating in the member's case in accordance with applicable state law and contract ; develops , monitors, evaluates, and revises the member's care plan ... member's needs, with the goal of optimizing member health care across the care continuum. **How you...members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. +… more
- Elevance Health (Latham, NY)
- …administration of behavioral health medical services, to ensure the appropriate and most cost effective medical care is received. May be responsible for ... developing and implementing programs to improve quality, cost , and outcomes. May provide clinical consultation...as clinical/strategic advisor to enhance clinical operations. May identify cost of care opportunities. May serve as… more
- Elevance Health (Latham, NY)
- …and post payment auditing. + Correlates review findings with appropriate actions ( provider education, recovery of monies, cost avoidance, recommending sanctions ... and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and … more
- Sedgwick (Albany, NY)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... benefits due, and manages action plan pursuant to the claim or client contract . + Manages subrogation of claims and negotiates settlements. + Communicates claim… more
- Sedgwick (Albany, NY)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... benefits due, and manages action plan pursuant to the claim or client contract . + Manages subrogation of claims and negotiates settlements. + Communicates claim… more
- Intermountain Health (Albany, NY)
- …case development, financial modeling, and the related analysis and total cost of ownership understanding and analysis, implements demand management strategies, ... regulatory compliance tracking. Leads the dispute resolution process on contract items and ensures a high level of ...sourcing and / or category management within the health care industry. - and - Healthcare product knowledge **Physical… more
- Sedgwick (Albany, NY)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... administers action plan pursuant to the claim or client contract . + Administers subrogation of claims and negotiates settlements....not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in… more