- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …+ Work with insurance carriers and MSKCC billing departments to initiate appeals and acquire authorizations for treatment **Key Qualifications:** + Current NYS ... Registered Nurse License/Registration and BSN preferred + At least 2-3 years of clinical hospital nursing experience + Managed care/UR/CM experience strongly preferred + Knowledge of state and federal regulations that govern health insurance coverage +… more
- Tutor Perini (New York, NY)
- …Representative** at Frontier-Kemper-Tutor Perini joint venture, reporting to the **Safety Manager ,** you will be responsible for overseeing and enforcing the health ... safety, health, and insurance inspectors during site walkthroughs. + Prepare written appeals for any safety violation citations. + Perform additional tasks assigned… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... and/or escalates denial when appropriate. + Submits all (initial and/or appeals ) reviews and/or letters within contractual or regulatory timeframes. + Collaborates… 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
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization/ appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance and regulatory audits and provides… more
- Molina Healthcare (Yonkers, NY)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider ... Manages staff responsible for the submission/resolution of member and provider inquiries, appeals and grievances for the Plan. Ensures resolutions are compliant. +… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements.../ Off-site Insurance reviews + Implements first step of appeals process to assist Appeals Nurse and… more
- Molina Healthcare (Yonkers, NY)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and ... * Leads, organizes, and directs the activities of the Appeals & Grievances unit that is responsible for reviewing... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- CUNY (Brooklyn, NY)
- Manager of Student Advocacy and Accountability (HEA) **POSITION DETAILS** New York City College of Technology of the City University of New York (CUNY), a ... Brooklyn offering associate and baccalaureate degrees, invites applications for a Manager of Student Advocacy and Accountability. Reporting to the Vice President… 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
- MVP Health Care (Tarrytown, 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
- J&J Family of Companies (New York, NY)
- …Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the Bay Shore, ... help overcome challenges to fulfillment, on-boarding, and adherence. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead… more
- Amgen (New York, NY)
- …us and transform the lives of patients while transforming your career. **Field Reimbursement Manager - New York Metro** **What you will do** Let's do this. Let's ... change the world. In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region for Patient Access and… more
- City of New York (New York, NY)
- …hearings by mail, web, and mobile app. In addition, the judges hear appeals of parking ticket determinations, and a special unit for Commercial Adjudications ... conducts hearings and appeals on tickets issued to commercial vehicles. The Customer...Analyst (Non-Managerial Level 2) to serve as the Operations Manager for the STARS Modernization Project. The selected candidate… 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
- The Nightingale-Bamford School (New York, NY)
- ANNUAL GIVING MANAGER The Nightingale-Bamford School is seeking candidates for the position of annual giving manager to join the school's advancement team. The ... Fund. Reporting to the assistant director of institutional advancement, the annual giving manager will advance the continued growth of the Nightingale Fund, with a… more
- City of New York (New York, NY)
- …- Investigates and advises the agency concerning contract disputes, and appeals on the rejection of equipment, materials, or workmanship; compiles contract ... or encapsulation of lead contained in or on any surface. CONSTRUCTION PROJECT MANAGER - 34202 Qualifications 1. A four-year high school diploma or its educational… more
- Elevance Health (New Hyde Park, NY)
- ** Manager , Medical Director - Transformation Initiatives** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... required by law. Alternate locations may be considered. The ** Manager , Medical Director** will serve as a clinical and...the United States when conducting utilization review or an appeals consideration and cannot be located on a US… more
- CUNY (Bronx, NY)
- Associate Director of Compliance and Operations (Financial Aid Manager ) **POSITION DETAILS** The City University of New York (CUNY), the nation's largest public ... aspects of financial aid, from application and award to disbursements, appeals (including special circumstances, professional judgments). + Develops and implements a… more
- Adecco US, Inc. (New York, NY)
- **Job Title:** Field Reimbursement Manager (FRM) - Remote with Territory Travel **Location:** Remote - Must reside in NYC **Travel:** Up to 80% (4 days/week) via ... automobile or air **Position Overview** We are seeking a **Field Reimbursement Manager (FRM)** to support access and reimbursement services for a specialty… more
