- VNS Health (Manhattan, NY)
- …to, Provider Relations, Claims, Medical Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and grievances. + Ensures ... to day activities for staff handling of grievances and appeals for one of the following VNS Health Plans...subcontractors who have delegated responsibility for managing grievance and appeals on behalf of the plan to ensure operational… more
- RWJBarnabas Health (Oceanport, NJ)
- Manager , AppealsReq #:0000169981 Category:Leadership Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department: Appeals Location: ... is an integral part of our company's success The Manager of theAppeals teamwithin the RWJ Barnabas healthcare facilities...a plus either in Utilization Review, Case Management or Appeals + Focused denials and appeals management… 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
- Mount Sinai Health System (New York, NY)
- …to Case Managers and other hospital personnel as needed. The Nursing Clinical Manager collaborates with Appeals Management, Managed Care Contracting, and other ... **Job Description** **The Nursing Clinical Manager (NCM) for Case Management - Mount Sinai...Case Management - Mount Sinai Hospital** The Nursing Clinical Manager (NCM) for Case Management is responsible for the… more
- Mount Sinai Health System (New York, NY)
- …to Case Managers and other hospital personnel as needed. The Nursing Clinical Manager collaborates with Appeals Management, Managed Care Contracting and other ... **Job Description** The Nursing Clinical Manager (NCM) for Case Management is responsible for...performance evaluation, performance improvement, and staff education. The NCM Manager serves as a resource/mentor for Case Managers, Social… more
- Mount Sinai Health System (New York, NY)
- **Job Description** This position serves as Appeals Analyst for Central Billing Office management. Responsible for monitoring contractual allowances, analyzing and ... pursuing appeals opportunities with payors and networks, and reporting performance...and analyzes data in our contract compliance tool (Contract Manager ), EPIC, and payor policy detail for identified payment… more
- Mount Sinai Health System (New York, NY)
- …and other operational details. This individual typically reports to a manager , director or division head. **Qualifications** + Associates Degree in Secretarial ... 2-3 years administrative or medical office experience required , 416 - HSO Appeals Management - MSH, Mount Sinai Hospital **Responsibilities** 1. Serves as an… more
- Mount Sinai Health System (New York, NY)
- …setup and testing. 2. Work in conjunction with internal matrix partners (PFS, Appeals , UM/CM) to identify, categorize and track issues related to payer contracts. ... operational efficiencies and market share. 5. Collaborates cross- functionally with PFS, Appeals , UM/CM and other internal stakeholders on more complex issues to… 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 ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals + Communicates clinical information to the payor, as… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager (CM) will be responsible for all aspects of case management for an assigned group of inpatients to determine the appropriateness ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals 5. Communicates clinical information to the payor, as… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients and ... basis and identify the expected length of stay (ELOS). The case manager works collaboratively with physicians, social workers, clinical nurses, home care services,… more
- Mount Sinai Health System (New York, NY)
- …Responsible for the maintenance of accurate data for approvals, denials and appeals (in coordination with UM Manager and management). Prioritizes insurance ... designation of alternative level of care with the UM Manager and/or Program Manager and Physician. Notifies...second level of appeal. Prepares concurrent review information for Review/ Appeals Nurses Meets timeframe for reviews/ appeals as… more
- IQVIA (New York, NY)
- **S** **r Care Manager ** As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams ... Summary:** AllCare Plus Pharmacy, an IQVIA company, is seeking a Sr Care Manager Responsibilities will vary by program and its lifecycle. Sr Care Manager… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE CONSTRUCTION PROJECT MANAGER CIVIL SERVICE TITLE, OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... Operations, Bureau of Construction Management is recruiting for one (1) Construction Project Manager II to function as a Senior Construction Project Manager , who… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations within a ... and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and coordinate the… more
- IQVIA (New York, NY)
- Care Manager As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma ... **Position Summary:** AllCare Plus Pharmacy, an IQVIA company, is seeking a Care Manager ! Responsibilities will vary by program and its lifecycle. Care Manager 's… more
- KPMG (New York, NY)
- **Business Title:** Manager , Risk **Requisition Number:** 118222 - 68 **Function:** Advisory **Area of Interest:** **State:** NY **City:** New York **Description:** ... consider a career in Advisory. KPMG is currently seeking a Manager in Non-Financial Risk for our Consulting (https://advisory.kpmg.us/) practice. Responsibilities: +… more
- Citigroup (New York, NY)
- **Business Relationship Manager ** The Business Relationship Manager (BRM) is responsible for proactively sourcing, acquiring, expanding, and retaining customer ... to facilitate loan closings, including pipeline management, loan escalations / appeals and advocacy, application quality and pricing issues + Strictly adhere… more
- Ascendis Pharma (New York, NY)
- …with potential for best-in-class efficacy and safety. The Field Reimbursement Manager (FRM) is responsible for minimizing reimbursement barriers for patients and ... other field sales force personnel and region management. The Field Reimbursement Manager will achieve objectives by working closely with internal and external… more
- Mount Sinai Health System (Astoria, NY)
- **Job Description** The Clinical Risk Manager in the Department of Risk Management is responsible for the day to day risk management activities at Mount Sinai Queens ... of Health; and conducting risk management educational programs. The Clinical Risk Manager is responsible for the coordination and investigation of serious adverse… more