The Clinical Analytics & Informatics department has an opening for a Clinical Analyst. This person is responsible for converting business problems and needs into analysis and reporting using an understanding of clinical data sets, systems and programming scripts. The Clinical Analyst will work with Clinical Services and IT to deliver useful analysis and reports according to business and technical specifications.

The Claims Coding Analyst’s primary responsibilities include maintaining and enhancing our clients claims editing systems to ensure proper claims payments, reviewing, researching, and responding to written and emailed correspondence from providers regarding claim denials based on clinical coding policies, and acting as a subject matter expert and handling more complex provider issues. They ensure that our clients payment policy is aligned with CMS (Centers for Medicare and Medicaid Services), New York State Department of Health (NYSDOH), and all CPT, HCPCS, and ICD-10 coding guidelines, among others..

As an associate you will have the opportunity to perform routine diagnostic and analytic testing of laboratory specimens independently for our client.

As an Associate you will have the opportunity to perform routine diagnostic and analytic testing of laboratory specimens independently for our client.

This position ensures that prospective new and active enrollees/members are appropriately screened by assessment staff to meet eligibility requirements. Ensures that an initial and ongoing service plans are developed implemented and communicated with all relevant parties. In addition, you will be required to direct the daily operations of scheduling, staffing needs and clinical coordination.

The Onsite Care Manager performs assessments and reviews discharge planning for our members. This position has face-to-face member contact depending on the hospital's limitations and stipulations. The Onsite Care Manager collaborates with hospital clinicians and a care management team (which may include RN’s, Social Workers, and Coordinators) to evaluate and treat members and provides education and consultation to members, family/caregivers, and other people responsible for the member’s shared care.