- Mount Sinai Health System (New York, NY)
- **Job Description** The Provider Data Management and Credentialing Specialist is responsible for ensuring the data integrity for contracted ... across the departments multiple processes such as Credentialing and Provider Data Management activity. 2. Participates in ongoing sanctions monitoring… more
- Molina Healthcare (Yonkers, NY)
- …delivery + Overseeing implementation of scalable solutions for provider onboarding, data management , and credentialing operations + Leading change ... **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new… more
- Molina Healthcare (Yonkers, NY)
- …**Job Summary** Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk ... daily/weekly production goals and maintaining a high level of confidentiality for provider information. **Job Duties** * Evaluates credentialing applications for… more
- Molina Healthcare (Yonkers, NY)
- … Information process functions. * Directs the development, implementation and maintenance of provider data in the claims payment system. * Supports critical ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Molina Healthcare (Yonkers, NY)
- …design solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience, Enrollment, and Claims ... equivalent combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or equivalent… more
- Molina Healthcare (Yonkers, NY)
- …contracting, network management and credentialing . **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous quality of provider data and ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Molina Healthcare (Yonkers, NY)
- … databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of ... business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of… more
- Molina Healthcare (Yonkers, NY)
- …timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, ... business rules as they apply to each database. Validate data to be housed on provider databases...requirements of customers as it pertains to contracting, network management and credentialing . **Job Duties** This role… more
- Molina Healthcare (Yonkers, NY)
- …as related to transitions and implementations of existing plans with regards to provider data . + Organizational expert in responding to legislative and ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Centene Corporation (Queens, NY)
- …that incentivize better patient outcomes, cost-efficiency, and quality care + Uses data analytics to track and monitor provider performance, offering actionable ... flexibility. **Position Purpose:** Responsible for maintaining existing and developing new provider relations, and improving provider performance and metrics. +… more
- Molina Healthcare (Yonkers, NY)
- …customers as it pertains to contracting, network management and credentialing . **KNOWLEDGE/SKILLS/ABILITIES** + Audits loaded provider records for quality ... critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules… more
- Catholic Health Services (Rockville Centre, NY)
- …Care Unit, and has received Pathway to Excellence designation from the American Nurses Credentialing Center - the only hospital in the region and one of only two ... State to receive this prestigious award. Job Details Critical Care Advanced Practice Provider Job Summary: + The Critical Care Advanced Practice Provider (CCAPP)… more
- Molina Healthcare (Yonkers, NY)
- …to business and system requirements of stakeholders as it pertains to provider contracting, network management , credentialing , benefits, prior ... and maintenance of critical information on all claims and provider databases, validate data housed on databases...+ Knowledge of validating and confirming information related to provider contracting, network management , credentialing ,… more
- Insight Global (New York, NY)
- …Consider requiring or preferring certifications such as CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional Medical ... role when the PE team is: scaling efficiently, making high quality, data -driven decisions, and embracing a culture of continuous process improvement. We're looking… more
- BronxCare Health System (Bronx, NY)
- …Coaching and performance reviews for various clinic locations. - Identifies that provider credentialing information is consistent in each system along the ... Improvement activities of the assigned department. Contribution and participation includes data collection, analysis, implementation of and compliance with risk … more
- Medtronic (New York, NY)
- …sales needs to achieve the district (s) CDS goals. Primary responsibility is to provide daily case coverage for all CDS implants and ensure the availability and ... CDS products post sign-off, while working on driving account independence * Provide troubleshooting support as requested * Successfully completes CDS Field Technical… more
- AbbVie (New York, NY)
- …. Job Description Perform all aspects of account management , including developing and maintaining strategic business relationships with ... corporate/senior management staff in key accounts with the goal of...evaluate and penetrate non-retail account drivers within MSAs. + Provide strategic and tactical direction regarding target accounts to… more
- Walgreens (New York, NY)
- …interactions, and allergies to suggest alternative medications, and answer medical provider questions. diagnostic testing, disease state management and other ... wellness services or strategy information to pharmacy staff. Business Performance Management + Analyzes performance data including pharmacy financials, customer… more
- Abbott (New York, NY)
- …+ Data entry into Salesforce, Mentor software for customer case support management + Learn commercial data analytics, resources & tools for effective ... life through the design and provision of device and management solutions for the treatment of STRUCTURAL HEART disease....of the Clinical Sales Specialist (CSS) role is to provide TAVI clinical trial and commercial case support, trial… more
- Molina Healthcare (Yonkers, NY)
- …waste, or abuse. + Coordinates with various internal customers (eg, Provider Services, Contracting and Credentialing , Healthcare Services, Member Services, ... investigations, including but not limited to witness interviews, background checks, data analytics to identify outlier billing behavior, contract and program… more