- City of New York (New York, NY)
- … Director of OHSSA. This position will also serve as the inaugural Director of Healthcare Accountability, leading strategy and implementation for Local Law ... the Agency's Chief Medical Officer. The BEHS is the healthcare systems bureau of DOHMH. Our mission is to...routinely update their interpretation in accordance with a highly complex , rapidly evolving regulatory environment. - Stay informed of… more
- Molina Healthcare (Yonkers, NY)
- …years leadership/supervisory experience required * Progressive management experience to manage complex work systems and workflows required * Knowledge of pre-edit ... Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims *...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Director , Hospital Contract Compliance will oversee the contract compliance program, ensuring the organization's contracts, specifically ... related to healthcare billing (hospital and professional), adhere to internal policies,...contract compliance monitoring, risk identification, and issue resolution. The Director will collaborate with various internal departments, including legal,… more
- Ankura (New York, NY)
- …excellence founded on innovation and growth. Ankura's Global Disputes and Economics Healthcare and Life Sciences Practice is searching for a talented individual to ... firms in the United States. Ankura's Disputes and Economics Healthcare and Life Sciences Practice is the largest industry...in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act;… more
- EPAM Systems (New York, NY)
- …- go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit, ... and technology solution expertise. You'll drive the shaping and delivery of complex solutions, working with cross-functional teams in both business and technology.… more
- City of New York (New York, NY)
- …for the City of New York, you will receive excellent benefits, including healthcare , vision benefits, dental benefits, as well as the opportunity to participate in ... York City Employees' Retirement System Membership and Service Division seeks a Deputy Director . Under the direction of the Membership and Service Director , the… more
- Mount Sinai Health System (New York, NY)
- …behalf of Mount Sinai Human Resources partners, the Pharmacy Benefits Program Director is responsible to provide service support, reporting, pricing, and/or other ... stakeholders and other external vendors. The Pharmacy Benefits Program Director serves as the primary pharmacy benefits subject matter...required. + Minimum of 6 years experience in the healthcare industry, with focus on Pharmacy Health Plan or… more
- City of New York (New York, NY)
- …most impacted NYC communities. CHECW addresses inequity across community and healthcare systems in partnership with community, faith-based, and health care ... Agency's Chief Medical Officer. The Bureau of Equitable Health Systems (BEHS) is the healthcare systems bureau of DOHMH. Our mission is to apply policy evidence, and… more
- City of New York (New York, NY)
- …most impacted NYC communities. CHECW addresses inequity across community and healthcare systems in partnership with community, faith-based, and health care ... Chief Medical Officer. The Bureau of Equitable Health Systems (BEHS) is the healthcare systems bureau of DOHMH. Our mission is to apply policy, evidence, and… more
- CVS Health (New York, NY)
- …human connections with our customers every day. As we, seek to simplify a complex healthcare system for the patients we serve, while delivering disruptive ... to the adjudication and processing of pharmacy and medical claims and newly expanded healthcare services. Create...Applications + Ability to communicate and influence mid-level managers ( Director and above), as demonstrated by 3+ years of… more
- Otsuka America Pharmaceutical Inc. (New York, NY)
- …field organization. 2. Build, maintain and leverage networks and relationships in the complex healthcare ecosystem to gain insight into customer needs and ... on patient, caregiver and HCP needs in an evolving healthcare environment. The new model is built around where...The Ecosystem Lead will report to a Sr. Business Director (SBD) and be grouped into a regional area.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Clinical Risk Manager reports to the Director of Risk Management and Patient Safety and is responsible for reviewing, summarizing, analyzing, ... presenting and monitoring safety events, claims management, loss prevention and reduction, patient safety related quality improvement activities and supporting the… more
- Mount Sinai Health System (New York, NY)
- …and other accrediting agencies. This individual, in conjunction with the Senior Director , participates in the orienting, training and mentoring new staff to the ... Management & Patient Safety Department. This involves collaborating with the Senior Director to develop educational plans for instructing staff about the medical… more
- Mount Sinai Health System (New York, NY)
- …of patient benefits. + Works closely with the Nursing Clinical Director , Physician Leader, and staff to ensure that assigned department/unit maintains ... for the services provided. + Current experience with prior authorizations, claims , appeals, discharge planning. + Licensed as a registered professional nurse… more
- City of New York (New York, NY)
- …most impacted NYC communities. CHECW addresses inequity across community and healthcare systems in partnership with community, faith-based, and health care ... the Agency's Chief Medical Officer. The Bureau of Equitable Health Systems is the healthcare systems bureau of DOHMH. Our mission is to apply policy, evidence, and… more
- BronxCare Health System (Bronx, NY)
- …team, which will be composed, of the Chairman of the Department, Executive Director , Clinical Director and the Co-Directors of the Dental Residency Training ... community hospital or community health center. Responsibilities - Reports to the Director of Ambulatory Services, will be resposible for successfully managing and… more
- Mount Sinai Health System (New York, NY)
- …in collaboration with the pharmacy leadership team under the direction of Senior Director of Ambulatory Pharmacy and the Chief Pharmacy Officer. The scope and ... from PBM prescription portal for QA report and analyzing + Reviewing pharmacy claims to identify outliers, utilization and prescribing trends + Adhoc duties based on… more
- Mount Sinai Health System (New York, NY)
- …Description** The Senior CBO Revenue Cycle Manager reporting to the Senior Director of CBO Operations, is responsible for directing and coordinating the overall ... meetings with department staff and providers to provide information/feedback on claims /denials to ensure optimal AR management. Analyzes Department metrics to assess… more
- Mount Sinai Health System (New York, NY)
- …benefits, claims , care coordination and other complexities of the healthcare system. This will include explaining complicated medical and benefits terms in ... Sinai, we are looking for people to join our team who want to make healthcare better by improving the value of care for patients, purchasers, and communities. To… more
- Mount Sinai Health System (New York, NY)
- …Senior CBO Appeals Analyst position requires an in-depth knowledge of healthcare pricing/reimbursement processes and procedures including institutional, as well as ... Five years minimum of managed care experience in insurance claims or contracts Four to Five years of financial...to Five years of financial analysis experience in a hospital/ healthcare environment is required. Advanced knowledge of Epic, Contract… more