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Certification/s: PHR/SPHR/CP/SCP preferredAt least three (3) years prior experience processing NYS workers’ compensation claims and/or FMLA leaves of absence, is preferred. At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception.
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Working knowledge of health care EMR or claims systems (Epic/Clarity, eCW, Facets, QNXT, Amisys, etc.) Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or financial decision support required.
$86,000 - $165,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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The Customer Service Representative provides assistance to passengers and crew throughout the different stages of travel through our Jet Aviation FBOs. This position serves as the main point of contact for service requests, inquiries, suggestions, and complaints.
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As a Large Loss Claims Experience Advocate, you’ll help us settle claims quickly and efficiently, surpassing customer expectations along the way. We don’t care much about titles and hierarchy and instead focus on innovation, bold moves, and challenging the status quo.
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The Data Management Specialist will be responsible for managing and optimizing our organization's data infrastructure, ensuring data quality, and implementing data solutions using PySpark, DataBricks, Snowflake, and/or Redshift.
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The Claims Adjuster are sent to client’s homes for pre-loss assessments & inventory, post-loss assessment & inventory, collections cataloging, reconstruction post loss including compiling inventory lists, photos, and in-depth client interviews.
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Key stakeholder departments include, configuration, provider relations, provider credentialing, provider enrollment, claims, medical management and payment integrity. Bachelor's degree in Business, Finance or related field, plus 5-7 years of experience in the health care industry (at least 3 years in managed care contracting), or an equivalent combination of education and experience.
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Our single doctor practices offer care for common urgent cases, including wound management, ear infections, vomiting/diarrhea, and euthanasia, and each of our paperless clinics is specially designed to deliver efficient care and equipped with cloud-based EMR, digital x-ray, and a full suite of IDEXX in-house lab equipment.
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Three plus years of hands-on experience with Epic Resolute Billing in a real-time environment with Claims as they relate to the Resolute Module. Project management skills including the ability to lead meetings, prioritize, resolve conflicts, and manage project plans.
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As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics.
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Partners with local SPHS leadership and acts as Medical Director for the SPHS Value-Based Care Management team responsible for GMG patients. Guides the creation and implementation of new clinical care delivery models at SGMF focused on the provision of superb clinical care in a “Value-Based Care / Population Management” environment.
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Technical evaluation of pharmaceutical industry data sources including claims, EHR, specialty pharmacy, sales, and customer master data. Leverage analytic tools and platforms in support of data evaluation and management activities, e.g. Tableau, Dataiku, Snowflake, Hadoop, Spark, SQL to evaluate data coverage, quality, interoperability, and fit within Pfizer's existing data ecosystem.
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Our continued success is achieved through our omnichannel fluency and curated digital suite of capabilities, including Account Services, Creative, Digital and Brand Strategy, Digital Production and Project Management, 3D Animation, Digital Development, and Video.
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8 years of progressive management and leadership experience with a proven track record; and experience in the foster care and child welfare realm. The Vice President, Foster Care oversees The Foundling’s programming for youth and families involved in the foster care program operating throughout New York City, and Residential program in the Bronx, managing a program slot capacity in Enhanced Foster Care of 480, Residential Young Parenting Program of 36 and foster homes of 450+, while strategizing to increase contract for business growth.
$155,000 - $176,600 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Services are readily accessible and include: inpatient, outpatient, partial hospitalization, screening, crisis stabilization, family/caregiver support, community outreach and case management, supportive housing, supported employment, prevention and consultation, employee assistance programs, and a licensed therapeutic school from preschool through high school.
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claims complaints care management jobs Company: Metroplus Health Plan in Newark, NJ
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