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About NYC Health + Hospitals MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
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The Psychiatric ED Technician will effectively and efficiently coordinate with the ED attending to formulate a disposition plan and document it in the medical record Prior to discharge the ED technician will review the case with an ED Psych Screener (licensed practitioner.
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Render medical necessity coverage determinations in accordance with legacy Tufts Health Plan or Harvard Pilgrim Health Care Medical Necessity Guidelines and the member's EOC / benefit document.
$271,866 - $351,826 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch.
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Risk Adjustment Quality Assurance Auditor Senior - Health Plan Admin. CHRISTUS Irving Corporate Health Plan Administration Office. The Risk Adjustment Quality Assurance (RAQA) Auditor Senior will be involved with activities of compliance auditing and targeted quality assurance audits for the following programs, including but not limited to Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation.
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The Associate Director is responsible for improving and sustaining the quality of research at KIUR by providing review and input on research products, communicating findings to wide and varying audiences, and helping lead and strategically plan the development of the Community and Public Health research center.
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Performs utilization management activities in accordance with accreditation standards and regulatory guidelines described in legacy Tufts Health Plan or Harvard Pilgrim Health Care UM Policy and Procedure Manual.
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In conjunction with the Project Superintendent, the SSHO is also responsible for the development, management, communication, implementation, and enforcement of approved site-specific safety plans including, but not limited to the Accident Prevention Plan (APP), the Site Safety and Health Plan (SSHP), and the Environmental Protection Plan (EPP.
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In addition to maintaining a closely integrated alliance with The George Washington University and The George Washington University Hospital (GWUH), separately owned and operated by Universal Health Services (UHS), the GW MFA has active referring relationships with 12 area hospitals.
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These MHI shared services operations that support the Health Plan will have dotted line responsibility and accountability to this position. This role requires the identification and adoption of best practices from across the enterprise for Health Plan and MHI Service Operations; developing strategies and tactics in partnership with MHI Service Operations to mitigate any issues or performance levels not meeting established service levels and provides corporate oversight including the efficacy of vendor management.
$122,430.44 - $238,739.34 a yearExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services.
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IUHP also serves as the faculty practice plan of the IUSM and brings together IUSM faculty physicians, IU Health affiliated physicians and private practice physicians to give highly skilled doctors access to innovative treatments using the latest research and technology.
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Set and execute a strategic plan for the revenue enhancement and service components of the Kroc Center including Membership, Guest Fees, Rentals and Partner usage that supports the appropriate growth and the overall financial health of the organization.
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Reporting to the Vice Provost for Student Affairs and Dean of Students, the Managing Director, Lerner Health and Wellness functions as chief officer for the Lerner Health and Wellness Center.
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Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly.
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