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Director Care Coordination- Major Responsibilities Criteria A: Establishes and coordinates communication with all Utilization Regulatory Agencies i.e. Qualidigm, NGS, etc., State and Third Party Payers to address Utilization Management Issues and Denials.
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Monitoring of network uptime, availability, bandwidth utilization, configuration change monitoring and backups. Manage and control vulnerability management and security incidents of the Americas Region in collaboration with the HO.
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This experience typically includes: monitoring occupant space utilization, energy and water conservation, sustainability and environmental hazards programs; coordinating alteration and renovation projects; gathering information to assess the level of customer satisfaction, i.e., surveys, interviews with tenant contacts, focus groups; monitoring real property budgetary and financial data; and, administration of repair and/or operation and maintenance contracts.
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Information Security Processes: Identity and access management, privileged access management, generic ID management, threat intelligence, vulnerability management, secure coding practices, data security and encryption, phishing, forensics, mobile security, third-party, etc.
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Experience in at least 3 ServiceNow Applications such as IT Service Management(ITSM), Customer Service Management (CSM), Strategic Portfolio Management (SPM), IT Asset Management(ITAM), Governance Risk Compliance (GRC), IT Operations Management (ITOM) etc.
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Director of Risk Management & Regulatory Affairs ( Patient Safety Officer / Privacy Officer ) The Director of Risk Management and Regulatory Affairs (Patient Safety Officer/Privacy Officer) serves as an accessible resource to the hospital and community on risk management and regulatory issues.
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Ancillary neurologic services include EEG, EMG, and nerve conduction studies. Stroke management has been recognized by the AHA/American Stroke Association. They have their own Sleep Lab, EMG and EEG, Radiology Division, and Laboratory.
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Conduct capacity planning and resource utilization analysis to support scalability and growth of Oracle/Exadata environments. Utilize Oracle Enterprise Manager (OEM) for deployment, monitoring, and management of Exadata environments.
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Key treasury activities include: cash and liquidity management; cash forecasting/modeling; credit facility and other debt management; financial risk exposure management, optimization of Treasury technology, remittance processing and escheatment for unclaimed property.
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The EHS Specialist provides hands-on management to the site level plant management teams specific to Environmental, Health and Safety (EHS) requirements. · Works with plant management to develop EHS operating and capital budgets.
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Qualified candidates will have prior LTSS or Medicare Inpatient Utilization Management experience within a Managed Care setting, LTSS, MLTC MAP, will have a NYS Registered Nurse License , familiar with MCG/Milliman/Interqual Guidlines and a desire to join a great team.
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Experience in information security or network/system administration, including IT auditing, IT compliance, and enterprise risk management. Build, coordinate, maintain, change, and keep updated, the Risk Management Framework (RMF) Assessment and Authorization (A&A) packages.
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By leading market level projects and strategies for provider engagement, this position will drive optimal performance on quality, risk adjustment, utilization management, financial performance, and membership growth.
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Professional Fee Specific: Responsible for coding Surgical Records, Evaluation & Management Encounters, ED (with E&M) and as needed Diagnostic, HCC, Retrospective Coding, Documentation Quality Assurance, and Ancillary records.
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The Vice President of Supply Chain Management will play a critical role in overseeing and optimizing the end-to-end supply chain processes within CNE. This strategic leadership position requires a seasoned professional with a proven track record in supply chain management, logistics, and procurement, particularly within the healthcare industry.
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utilization management ancillary jobs Company: Metroplus Health Plan in New York, NY
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