Case Manager, RN (Complex Pediatrics)
Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member’s case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review
Capital District Physicians' Health PlanLegal Documentation Specialist
Job Description: Summary: This position drafts and reviews provider contract documents, provides assistance and responds to internal and external inquiries of pertinent regulatory and provider contracting issues. Essential Accountabilities: Works with Corporate Counsel and others in Legal Department to develop draft template provider contracts for all provider types that keep current with regulatory, BCBSA and other entities as necessary for required language and terms. Accountable for drafting and
Capital District Physicians' Health Plan