Top 698 Claims manager Jobs in New York Ny

Pre-Authorization Unit Manager
MJHS —New York, NY
- $135,000 - $150,000 a year
- Full-time
- Management
- Mid-level
PreAuthorization Unit Manager
MJHS —New York, NY
- $135,000 - $150,000 a year
- Full-time
- Hybrid work
- Management
- Senior level
- Health insurance
- Dental insurance
Manager, Benefits Coordination and Claims
EmblemHealth —New York, NY
- $77,760 - $149,040 a year
- Microsoft Outlook
- 5 years
- HIPAA
Manager, Hospital Claims
1199SEIU Family of Funds —New York, NY
- $104,500 - $130,600 a year
- Full-time
- Microsoft Word
- Microsoft Excel
- Inventory management
10d
Claims Manager, Audit & Complaints
MetroPlus Health Plan —New York, NY
- $100,000 - $120,000 a year
- Full-time
- Hybrid work
- 5 years
- Research
- Office
Manager of Claims & Encounter Analytics and Reporting
AMIDA CARE INC. —New York, NY
- $98,819 - $123,534 a year
- Full-time
- Microsoft Excel
- 5 years
- Research
Quick Apply
Regional Risk Manager
Tutor Perini Corporation —New Rochelle, NY
- $125,000 - $150,000 a year
- Full-time
- 5 years
- Office
- US work authorization
Senior Project Manager - Pumping Station Reconstruction
Inter Contracting Corp. —Brooklyn, NY
- $225,000 - $275,000 a year
- Full-time
- Construction site
- Contracts
- In-person
- Health insurance
- Dental insurance
Quick Apply
13d
Senior Property Manager - Residential Rentals
Confidential —New York, NY
- From $150,000 a year
- Full-time
- Background check
- Residential
- Apartments
- Health insurance
- Dental insurance
Quick Apply
BUSINESS TECHNOLOGY MANAGER - GUIDEWIRE INSURANCE SUITE - AVIATION INSURANCE
United States Aviation Underwriters, Inc./USAIG —New York, NY
- $140,000 - $200,000 a year
- Full-time
- Hybrid work
- Background check
- Azure
- Computer Science
- Health savings account
- Health insurance
Quick Apply
Construction Safety Manager
Signature Safety, LLC —Queens, NY
- $42 - $52 an hour
- Full-time
- Construction site
- Mid-level
- In-person
- AD&D insurance
- Health insurance
Quick Apply
14h
SVP Lead Underwriter, Property Cedant Facultative Reinsurance, North America
SCOR —New York, NY
- $290,000 - $390,000 a year
- Hybrid work
- 11+ years
- Office
- Accounting
- AD&D insurance
- Paid holidays
SVP - Lead Underwriter, Construction, Cedant Facultative Reinsurance
SCOR —New York, NY
- $290,000 - $392,500 a year
- Hybrid work
- 11+ years
- Office
- Accounting
- AD&D insurance
- Paid holidays
Senior Tax Manager
Miller & Company LLP —Whitestone, NY
- $150,000 - $185,000 a year
- Full-time
- Management
- CPA
- Computer literacy
- Profit sharing
- Health insurance
Quick Apply
15h
Safety Manager
Confidential —Brooklyn, NY
- $100,000 - $150,000 a year
- Full-time
- Construction site
- Driver's License
- Travel
- Profit sharing
- Health insurance
Quick Apply
Commercial Lines Account Manager
World Insurance Associates LLC —Iselin, NJ
- Full-time
- Microsoft Word
- Background check
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
Personal Injury Case Manager
Greenstein & Pittari, LLP —New York, NY
- $60,000 - $65,000 a year
- Full-time
- Spanish
- Mid-level
- In-person
- Profit sharing
- Health insurance
Quick Apply
10d
Assistant Property Manager
Confidential —Bronx, NY
- $80,000 - $95,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Mitigation Project Manager
Paul Davis Restoration of Brooklyn West —Brooklyn, NY
- $70,000 - $110,000 a year
- Full-time
- Clean driving record
- Mid-level
- Driver's License
- Paid training
- Paid time off
Quick Apply
Property & Casualty Claims Manager
SolomonEdwards —New York, NY
- $140,000 - $155,000 a year
- Email
- Mentoring
- Organizational skills
- In-person
Quick Apply

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claims manager jobs near new york ny

Pre-Authorization Unit Manager

MJHS -
New York, NY

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Job Details

Full-time
$135,000 - $150,000 a year

Qualifications

Collaborate with healthcare professionals
Management
Healthcare staff management
Webinars
Clinical program policy development
CMS
Mid-level
Quality control audit
Quality reports
Audit Reporting
CMS regulatory compliance
Pre-authorization review for utilization management
Medicare regulations
InterQual
Quality compliance management
Health record chart audits
Healthcare policy implementation
Webinars (training delivery method)
Regulatory compliance analysis
Documentation review
Policy Development
Healthcare data reporting
Staff development

Full Job Description

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Provides oversight of Pre-Authorization unit to ensure all organization determinations are within regulatory compliance for time frames and notification parameters through ongoing monitoring of the unit’s activity.

Development and direct oversight of all MLTC/MAP organization determination/authorization processes to ensure timeliness and compliance with CMS/DOH regulations.

Collaborates in development of goals, objectives and performance measures and outcomes for the Coordinated Care Department.

Reviews/Revises all workflows and policies for the Pre-Authorization unit on at least an annual basis to ensure compliance with DOH and CMS regulations. Communicates changes required for compliance within and outside of Coordinated Care Department, including Member Operations, Customer Service, Claims, Compliance, and Appeals and Grievances departments.

Ensures InterQual (IQ), internal policies and other criteria (NYS DOH, NCD, LCD) are applied consistently among staff through daily monitoring and review of the requests for services assigned to the unit. Educates staff on any changes to criteria/policy. Discusses with Director, the need for additional medical policy when gaps in coverage criteria are noted.

Conducts periodic focused medical records reviews for Pre-Authorization unit by using department specific audit tools and provides additional education as needed. Analyzes combined collected audit data and reports findings to Coordinated Care management. Works with Staff Educator on re-training efforts either on site or through Webinar sessions.

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Refine Your Search

claims manager jobs in new york ny

Pre-Authorization Unit Manager

PreAuthorization Unit Manager

Manager, Benefits Coordination and Claims

Manager, Hospital Claims

Claims Manager, Audit & Complaints

Manager of Claims & Encounter Analytics and Reporting

Regional Risk Manager

Senior Project Manager - Pumping Station Reconstruction

Senior Property Manager - Residential Rentals

BUSINESS TECHNOLOGY MANAGER - GUIDEWIRE INSURANCE SUITE - AVIATION INSURANCE

Construction Safety Manager

SVP Lead Underwriter, Property Cedant Facultative Reinsurance, North America

SVP - Lead Underwriter, Construction, Cedant Facultative Reinsurance

Senior Tax Manager

Safety Manager

Commercial Lines Account Manager

Personal Injury Case Manager

Assistant Property Manager

Mitigation Project Manager

Property & Casualty Claims Manager

I want to receive the latest job alert for claims manager in new york ny

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