- CVS Health (Albany, NY)
- …systems and on daily operations and programs + Responsible to support targeted quality audit projects. Report results and make recommendations eg, training ... service to our internal and external customers. **Position Summary** + Performs routine quality audits for network operations and claim testing for PPO … more
- Molina Healthcare (Albany, NY)
- …time and quality . + Audit loaded provider records for quality and financial accuracy and provide documented feedback. + Ensure that provider ... DESCRIPTION** **Job Summary** Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains… more
- Cardinal Health (Albany, NY)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... and continuous improvement. Accurately score interactions to gauge employee's quality performance based on organizational and departmental policies and requirements.… more
- New York State Civil Service (Albany, NY)
- … audit team members and work unit management and contribute suggestions and provide meaningful input during audit team and work unit meetings.* Prepare ... City Albany State NY Zip Code 12236 Duties Description Audit Execution* Conduct audit assignments in accordance...promote employee health and wellness* OSC Mentoring Program to network , contribute, and provide an opportunity to… more
- New York State Civil Service (Albany, NY)
- …Work Programs to promote employee health and wellness* OSC Mentoring Program to network , contribute, and provide an opportunity to strengthen competencies in a ... Performs audits in accordance with applicable auditing standards.* Analyzes areas for audit , assists in establishing scope and areas of risk, suggests approaches for… more
- Highmark Health (Albany, NY)
- …retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all...in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of… more
- Cardinal Health (Albany, NY)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... point of contact handling inbound calls, with ability to determine needs and provide one call resolution + Process enrollments via inbound fax, phone, and… more
- Humana (Albany, NY)
- …with upstream business partners such as Claims, Clinical Guidance, and the Provider Network to identify opportunities and drives initiatives that will ... midst of a people, process and technology transformation that will improve quality , timeliness and the overall experience for our associates, members and providers.… more
- PwC IT Services Co. (Albany, NY)
- …a centralized model to provide security services across the entire member firm network . Mandated at the network level, Network Information Security (NIS) ... strategies. They work to identify vulnerabilities, develop secure systems, and provide proactive solutions to safeguard sensitive data. Those in application security… more
- Cardinal Health (Albany, NY)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced...inquiry + Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related… more
- Cardinal Health (Albany, NY)
- …experience, preferred. Diploma or degree in relevant field desirable. + 3+ years' call quality audit experience strongly preferred. + 3+ years' experience in a ... remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer...that can be improved or celebrated. + Analyze and provide weekly & monthly trend analysis to leadership. +… more
- Datavant (Albany, NY)
- …presenting to leadership, clients, and your Team via Video or in person. + Solution provider and forward thinking + Detail and quality oriented as it relates to ... is powered by the largest, most diverse health data network in the US, enabling data to be secure,...with leadership on issues, opportunities, or challenges. + Lead Audit Team which receives requests from Payors + Review… more
- Nelnet (Albany, NY)
- …with the industry standards for compliance and information security issues to provide our customers with world class information security & compliance services. ... with the industry standards for compliance and information security issues to provide our customers with world class information security & compliance services. The… more
- Atlas (Albany, NY)
- …at any and every step of the project, and with a heart-led approach that puts quality and safety at the center of everything we do. We're just built to be better. ... the Atlas Laboratory Information Management System (LIMS) across a nationwide laboratory network . Another major duty is the coordinating and management of Atlas… more
- Datavant (Albany, NY)
- …life experiences to realize our bold vision for healthcare. The individual will provide superior quality by performing audits pertaining to risk adjustment ... is powered by the largest, most diverse health data network in the US, enabling data to be secure,...pertaining to auditing functions as assigned. The individual will provide superior customer experience by educating internally and externally… more
- Regeneron Pharmaceuticals (East Greenbush, NY)
- …for Inspection Readiness strategies in relation to any regulatory inspection or quality audit involving outsourced manufacturing, provides advice and on-site ... Manufacturing network in accordance with mandated regulatory requirements, Regeneron Quality Systems, and site expectations. In this role, a typical day might… more
- Datavant (Albany, NY)
- …the right format. Our platform is powered by the largest, most diverse health data network in the US, enabling data to be secure, accessible and usable to inform ... content to re-educate team on coding error trends + Train and provide ongoing teaching/technical assistance to internal staff/external partners + Oversee the… more
- New York State Civil Service (Albany, NY)
- …errors detected during, testing, implementation and/or daily use.* Develop and conduct Quality Assurance and User Acceptance Testing test scenarios and scripts.* ... Provide training and technical assistance for OMH Central Office,...operational audits or audits of internal controls to develop audit reports and make recommendations to management regarding policies,… more
- New York State Civil Service (Albany, NY)
- …Work Programs to promote employee health and wellness* OSC Mentoring Program to network , contribute, and provide an opportunity to strengthen competencies in a ... of solutions (at any point in their lifecycle); verifies requirement quality ; validates requirement value.* Requirements Management & Communication: Assists in… more
- Actalent (Watervliet, NY)
- …interpret plans, specifications, and submittals is essential. Responsibilities + Provide overall contract management for construction, including direct supervision ... relationships. + Assure projects meet all company standards for quality control. + Act as the primary point of...and the ability to complete an in-house jobsite safety audit . + Proficiency with Microsoft Project, Excel, Outlook, and… more