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Navigates Allscripts EMR (Acute Care) and communicates with Practice Administrative staff or Care providers to retrieve required clinical utilization data to facilitate insurance carrier review and expeditious authorization approval.
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Handle authorization process and obtain pre-certification approvals prior to service. Under the direction of the Patient Service Advisor Manager, the College of Dental Medicine is searching for a detailed oriented and knowledgeable Pre-Authorization Specialist.
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At this time, Sia Partners does not intend to pursue employment with applicants who will require now or in the future visa by our company for work authorization in the United States (i.e., H1-B visa, F-1 visa (OPT), TN visa, or any other non-immigrant status.
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Non-Dari/Pashto-speaking candidates with experience in case management and/or refugee resettlement services will be considered. Prior professional experience in refugee resettlement, social work, counseling, community organizing, human services, or related specialty preferred.
Starting at $55,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Subject matter expertise in Financial Planning & Analysis FP&A / Enterprise Performance Management EPM, Sales Performance Management (Quota / Territory Planning, Incentive Compensation Management), or Sales & Operations Planning S&OP / Integrated Business Planning IBP domains.
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Ensures that all inspections and testing is performed to comply with TJC, DOH, CMS, FDNY, DOB, and NFPA as assigned by the Assistant Director of Engineering for all HSS properties. Minimum of 5 years of management level experience in facilities/property maintenance, engineering and / or Critical Systems, installation and operation of Building Systems (HVAC, plumbing, Fire/Life Safety, etc.
$135,000 - $145,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Act as the EHS point of contact for the Defense Contract Management Agency (DCMA) for all contracts. Prior experience working for a Defense contractor (DOD) is strongly preferred. Champion the Company Performance System (SPS) Safety Lean Key as part of the management team.
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12+ years' experience in information security or risk management, with a resume that demonstrates progressive career development managing multifaceted projects while performing regular activities; prior CISO role required.
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Prior experience in flow cytometry is a must experience in immunology and tissue culture is a plus. Prior experience in flow cytometry, immunology, and/or tissue culture. Prior managerial ability and experience, are a strong plus.
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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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Foreign Medical Graduate; and, two (2) years of medical records review or utilization and case management experience; or. Clinical Document Specialist (CDIS): under the supervision of the leadership of the Director of Health Information Management or designee is responsible to review medical records for appropriate documentation that will assist to enhance appropriate documentation that will enhance reimbursement, and improve documentation in order to be in-compliance with regulatory agencies and reduce denials.
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Familiarity with data governance, master data management, metadata management, and related processes. He/she should have prior knowledge of data integration, data warehousing, modeling, business intelligence, and data visualization / presentation concepts.
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Experience in matters of regulatory body standards (e.g. OSHA, NYS, DOH, CDC), Workers Compensation, Disability Management & Workplace Accommodations, Workplace Health & Safety, and Medical Surveillance.
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Facilitates, administers Health Plan clinical operations functions- prior authorization, Part A and B services, Medication Reviews, HEDIS and STARs quality gap closure, promoting membership growth.
$123,000 - $150,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Candidate ideally has worked in marketing, influencer marketing, talent management, PR prior. ● 2-5 years of talent management and/or influencer marketing experience required for this position.
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utilization management doh prior authorization jobs Company: Metroplus Health Plan in Brooklyn, NY
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