Fidelis Care New York Jobs & Careers

17 jobs

Fidelis Care New York
The Utilization Management (UM) Clinician performs clinical reviews to assess medical necessity of a broad range of outpatient and inpatient services, while maintaining compliance with all regulatory requirements. Interfaces with medical directors, and both internal and external stakeholders, with regard to coverage for services, contract benefits and alternate resources available. This position i...

Fidelis Care New York
The Benefits Analyst supports the day to day administration of medical leave, health and welfare, and retirement plans; functions as a Benefit Plan subject matter expert and ensures compliance with regulatory guidelines and reporting; coordinates annual renewal and open enrollment; follows organization standards and adheres to departmental and state guidelines to maintain quality service. The Ben...

Fidelis Care New York
Position Summary: Perform work associated with promoting and restoring the health of Health and Recovery Plan (HARP) members by identifying member care requirements, documenting, and ensuring maximal access to high quality care across the continuum. Collaborate with Member, Health Homes, physicians, other interdisciplinary team members, and family members and/or supportive others to support and s...

Fidelis Care New York
Promotes and restores patient health by identifying patient care requirements and assuring quality of care in collaboration with physicians and multidisciplinary team members; provides emotional, psychological, and spiritual support to members, friends, and families; identifies developmental, physical, psycho-social and psychological needs to assess and coordinate appropriate services; develops pl...

Fidelis Care New York
Description The Director of Clinical Services leads and administers the Clinical Services Department which provides care coordination to individual members, based on disease or utilization patterns, in order to improve the quality of care they receive. The Director is responsible for the conduct and performance of the department staff, making sure all organizational procedures are followed accura...

Fidelis Care New York
The Care Manager RN works in the Managed Long Term Care division providing case management guidance and coordinating care for Fidelis members needing long term care services in the home. This position collaborates with physicians and multi-disciplinary team members, providers, members, and families to provide the best care possible for each individual client. Technical/Functional Expectations: Q...

Fidelis Care New York
Authorizes and reviews utilization of mental health and substance use services provided in inpatient and intermediate care settings; assists with discharge planning and ambulatory follow up activity provides member assistance with mental health and substance use issues, and participates in special utilization projects. General Competencies: Demonstrated experience establishing relationships and ...

Fidelis Care New York
The Medical Management Supervisor oversees individuals who perform work associated with promoting and restoring patient health. This position provides leadership to clinical staff regarding regulatory requirements for clinical service determinations. The Medical Management Supervisor manages staff directly involved with reviewing and making medical necessity determinations and functions as a liais...

Fidelis Care New York
The Supervisor of Provider Relations oversees and manages Provider Relations representatives in assigned region(s) to facilitate appropriate provider on-site education, problem resolution, partnership development and ensure optimum provider satisfaction, compliance with regulatory requirements and achievement of Fidelis goals and objectives.. This position helps to manage relationships with key pr...

Fidelis Care New York
The Medical Management Supervisor oversees individuals who perform work associated with promoting and restoring patient health. This position provides leadership to clinical staff regarding regulatory requirements for clinical service determinations. The Medical Management Supervisor manages staff directly involved with reviewing and making medical necessity determinations and functions as a liais...

Fidelis Care New York
Business Analyst III sought by New York State Catholic Health Plan, Inc., d/b/a Fidelis Care New York in Latham, NY. 40 hrs/wk. Duties: Serves as technical & process expert for initiatives involving Quality Health Care Mgmt; Performs analysis to define opportunities to create improved future state processes (end-to-end process flow dvlpmt); Conducts analysis of business & user's needs & forecasted...

Fidelis Care New York
Position Summary: Provides case management guidance to staff that provide care coordination for Fidelis Care New York members that need long term care services in the home; collaborates with physicians, multidisciplinary team members, providers, members, and families to provide the best care possible for each individual client. Adhere to clinical standards of care, departmental, and State guidel...

Fidelis Care New York
Authorizes new pharmacy requests and ensures accurate and timely service to eligible Fidelis Care New York members; employ superior customer service skills and work with both internal and external co-workers to adhere to quality care standards and provide the most efficient service possible. Interact with both internal and external customers to provide outstanding pharmacy services using excellen...

Fidelis Care New York
Position Summary: Supervises the day to day technical functions of the Pharmacy Technicians in support of quality pharmaceutical care. Lead in demonstrating excellent customer service skills and appropriate pharmacy monitoring; ensure excellent team customer service. Support quality, cost effective care, and clear communication channels between staff and customers. Develop productivity and qua...

Fidelis Care New York
The Director of Provider Relations oversees a regional staff of representatives and associates. The position facilitates appropriate on-site provider education, problem resolution and partnership development. The Director ensures optimum provider satisfaction, compliance with regulatory requirements and achievements of Fidelis Care goals and objectives by working collaboratively with key regional ...

Fidelis Care New York
The Provider Relations Representative assures that all provider orientations, site visits, access and availability studies are completed within established time frames. This position establishes and fosters strong positive relationships with key providers by coordinating and facilitating meetings and identifying on site enrollment opportunities. Technical/Functional Expectations: Provider Servic...

Fidelis Care New York
Fidelis Care, a $6 billion health care company, offers quality, affordable coverage to residents across the State of New York, including products available through Medicaid, Medicare and the NY State of Health. Fidelis Care was founded on the belief that all New Yorkers should have access to affordable, quality health insurance and that remains our mission to this day to our 1.2 million members T...