Utilization Management Reviewer - Buffalo

This position is responsible for coordinating, integrating and monitoring the utilization of behavioral health BH or physical health PH services for members ensuring compliance with internal and external standards set by regulatory and accreditation entities. · ...

This position is responsible for coordinating and monitoring the utilization of behavioral health services for members. · Performs pre-service clinical reviews to determine the appropriateness of services requested. · Clinical review telephonically or on-site depending on custome ...

This position coordinates utilization of physical health medical services for members ensuring compliance with internal and external standards. · ...

Company Overview · Managed Care Network, Inc. is an established managed care company committed to being an employer of choice in the Workers' Compensation and No-Fault marketplace. Guided by our core values, we foster a workplace where employees can thrive, grow, and take pride i ...

We are looking for a highly motivated individual who is passionate about technology and has a proven track record of successfully implementing digital solutions. · The Senior Technology Product Manager will lead the technical end-to-end development lifecycle of our software produ ...

The Middle Revenue Cycle - Clinical Supervisor will train and mentor Utilization Review, Clinical Documentation Integrity and Clinical Denials teams. They ensure the teams receive comprehensive education on policies, procedures, regulations, denials and clinical criteria. · ...

Job Title: Legal Contracts Manager Assistant · Location: Buffalo, NY, 14213 · PURPOSE STATEMENT: · The primary role of this position is to serve as a crucial liaison between business associates and legal counsel, facilitating the effective management of contract processes and doc ...

The Middle Revenue Cycle - Clinical Supervisor is responsible for training and mentoring Utilization Review, Clinical Documentation Integrity and Clinical Denials and Appeals teams. · ...

+as a quality assurance expert for a new cGMP manufacturing team ensure that appropriate cGMP quality systems are in place through review and approval of procedures including master batch records specifications and standard operating procedures impacting the safety identity stren ...

Title: Controller · Department: Accounting · Manager: Jennifer Battaglia · Job Description: The Controller manages property-level financial health, including AP/AR, monthly closing, budget variance analysis, and cash flow forecasting for the portfolio. Reporting to the CFO, this ...

As a member of the multidisciplinary healthcare team,the case manager affects a process of assessment planning facilitation and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective c ...

Analyze common area maintenance charges (CAM) and properly apply to tenants accounts receivable. Review all invoices, credit memos and cash applications for reasonableness, errors. · Review Lease information, manual or computerized; Verify payments, ledgers for property, square f ...

Analyze common area maintenance charges · Review invoices credit memos cash applications · Prepare spreadsheets with billing information Analyze recurring billing review each generated bill make changes. · ...

Project involves the implementation of Axiom Risk and Regulatory Product / Project Lead technical teams to develop Reports for Risk and Regulatory Technical Experience in implementing Regulatory and Risk projects Knowledge Experience of Tera-Data ETL Tools. · Mentors the team on ...

This candidate will work in the claims department analyzing delay claims brought against the State within a geographic region. · Lensa does not hire directly for these jobs but promotes jobs on behalf of its direct clients recruitment ad agencies and marketing partners. ...

The Portfolio Manager – Construction and Rehab will be responsible for the performing agency portfolio consisting of Fannie Mae, Freddie Mac, HUD, · Fannie Mae is a government-sponsored enterprise that provides financing for residential mortgage loans. · Freddie Mac is a governme ...

The Compliance Specialist-Senior will manage and monitor compliance activities related to PBD's accreditations, certifications, licenses, and regulatory requirements. · ...

Responsibility Overview: · Communicate with leasing agents regarding proposed and executed lease transactions for new and existing tenants · Assist with prospective tenant proposals, including LOIs and review of use restrictions and exclusivity provisions · Draft, review, and neg ...

We are building a serious disciplined finance department in-house and are looking for a Controller who wants to grow with the company and take on increasing responsibility as the portfolio expands. · Cash & Disbursements Review and approve vendor bills insurance taxes utilities a ...

+ Manage quality appropriateness safety and cost of medications + Conduct drug prior authorization exception and medical necessity reviews + Support providers pharmacies as needed to expedite treatment This position is responsible for provider patient and employer initiatives pro ...