Amida Care Work Values

Daily Duties at Amida Care:

Contracted, expanded, and managed the Manhattan network, which consists of large groups, radiologists, ancillaries, and individual providers. Managed large scale projects that consisted of recruitment and negotiations with various physician types for the purpose of providing the plan with a compliant MLTC and Medicare network. Reduced the usage of non-par providers by contracting with them and saving the company money by reducing overpayment to out of network providers. • Project manager for Access and Availability and Article 44 audits • Collaborated with the UM department on case management trainings • Contracted with various provider types including Home Care Agencies, Social Days, Adult Days, DMEs, Transportation, Nursing Homes, Home Infusion • Initiated contract audits to ensure compliance with governmental agencies • Reviewed network for provider deficiencies and contract with needed providers to fill the gap • Managed field staff, to ensure that all escalated provider issues are handled timely • Credentialed providers based on NCQA guidelines • Provided root cause analysis and resolutions for outstanding reimbursement issues

What they like about Amida Care:

Working in an organization that is technologically advanced, creative, and innovative is critical in your assessment of hiring companies. Less important to you are stability of the organization, the length of time an organization has been in business, and the business' plans for the future. You prefer a fast-moving company that will take risks to achieve its goals and objectives. The length of time the company has been in business is irrelevant. Maintaining status quo is unnecessary. You thrive on change, uncertainty and the upside of potential business risks, especially those associated with innovation. Stability for the long haul is not nearly as important as is working in an atmosphere that is charged with a sense of urgency and constant change.

Tags

Provider Relations, Manager, Provider Contracting, Director, Provider Claims , Provider Data Management, Provider Credentialing , Provider Recruiting, Project Management, Project Manager, Management, Marketing Management, Medicare, Root Cause Analysis, Account Manager, Banking Industry

Skills

Project Management, Project Manager, Management, Marketing Management, Medicare, Root Cause Analysis, Account Manager, Banking Industry, MS Word, Excel, Sharepoint, Visio, Powerpoint, Salesforce, Outlook, Facets, Contracting, Credentialing, Network Management, Medicaid, Audit Reveiw, Leadership, Network Development

These are some of the questions we asked our climbers about their experiences with Amida Care: