of Job Ensure prompt, efficient, accurate and timely claims adjudication of high dollar claims in accordance with the current policy benefits, limitations or exclusions. Provide resolution of provider inquiries and collaborate with internal departments. Provide feedback or suggestions to enhance current processes and/or systems. Responsibilities Research and adjudicate hig

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

We are seeking a non invasive Cardiology trained physician to join us in pursuit of high quality patient care to provide Cardiology services including but not limited to diagnosis, treatment, coordination of care, preventive care and health maintenance. The Ideal Candidate One to three years of cardiology clinical experience in an outpatient setting. Ability to diagnose a

Prepare journal entries, account reconciliations and other analyses as part of the month end close process. Ensure that the monthly close for EmblemHealth is performed timely, accurately and in accordance with Generally Accepted Accounting Principles (GAAP). Participate in the development and enhancement of internal controls over financial reporting and process improvemen

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

We are seeking a Nurse Practitioner to provide medical services in collaboration with our internal medicine physicians. Join us in pursuit of high quality patient care to provide full scope internal medicine services including but not limited to diagnosis, treatment, coordination of care, preventive care and health maintenance. Responsibilities Obtain and document patient

of Job Assess eligibility of members in need of community based long term support services (CBLTSS). Conduct UAS assessment in the members home or by telehealth (under NY State's regulations), and at skilled nursing facilities. Consult with health care providers to support assessment outcomes. Conduct needs assessment utilizing the UAS NY/DOH tool to determine members' qua

Identify opportunities to reduce medical expenses and collaborate with other areas to implement and monitor performance. Participate in product development, pricing, filing, and rating implementation of new products and strategies. Develop studies, analyses, and presentation materials needed to appropriately inform decision makers, Answer questions of less experienced sta

Underwrite existing medical and dental accounts, including Broker, Commercial and Labor and Government accounts, within published time frames. Underwrite new business portfolio including a mix of Large Group Experience Labor and Government, Commercial, Self insured, and Large Group Community Rated accounts. Advise the Underwriters in the Underwriting Leader's absence. Sup

Participate in managing the financial risk of EmblemHealth through complex underwriting of various businesses. Underwrite existing medical and dental accounts, including Broker, Commercial and Labor and Government accounts, within published time frames. Prepare employer reports and provides analysis for use in accessing level of risk and in consulting with clients (broker

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

of Position The Care Team Associate II serves as a member of the Care Team in the treatment and care of patients who assists providers with clinical services and administrative tasks to support population health guided best in class care. The position works under the supervision of the Practice Administrator and in collaboration with the Nurse Manager. The Care Team Associ

We are seeking a Physician Assistant who specializes in cardiovascular medicine and imaging to provide medical services in collaboration with our cardiology physicians. Join us to provide top notch care for cardiac patients including but not limited to conducting, recording and interpreting stress test results. Responsibilities Obtain and document patient history as appro