10 operator iii jobs found

We're People People. Are you? We're Sonesta International Hotels-the 8th largest hotel company in the U.S. (and growing fast ). With a dynamic mix of full-service and focused hotels across major cities, our diverse portfolio of owned, managed, and franchised properties means we're everywhere our guests need us to be. But here's the thing-we're not just in the business of hotels, we're in the business of people. We bring service with passion, loyalty with purpose, and create experiences that genuinely connect-delivering quality, value, and memorable stays across 1,000+ properties in eight countries (and counting). What this role is all about The Staff Accountant serves as a core financial operator and analytical partner supporting a full-service hospitality environment inclusive of Rooms, Restaurant, Bar, Catering, and Room Service operations. This role is responsible for real-time revenue integrity across PMS/POS systems, F&B and Rooms profitability analytics (COGS,...

Job Description: Summary: This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as required, to meet departmental time frames. Per department needs, may be responsible for additional hours. Essential Accountabilities: Level I Performs pre-service, concurrent and post-service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members' medical health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical review...

Job Description: Summary: This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as required, to meet departmental time frames. Per department needs, may be responsible for additional hours. Essential Accountabilities: Level I Performs pre-service, concurrent and post-service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members' medical health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical review...

Job Description: Summary: This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as required, to meet departmental time frames. Per department needs, may be responsible for additional hours. Essential Accountabilities: Level I Performs pre-service, concurrent and post-service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members' medical health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical review...

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 treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential...

Job Description: Summary: The Enterprise Regulatory Compliance Program Administrator evaluates new and evolving federal and state regulatory guidance and assesses their impact on enterprise-wide business processes, products, and operational strategies. This role partners closely with functional business areas to translate complex regulatory guidance into practical risk-based compliance solutions and supports the ongoing administration of an effective regulatory compliance program. The Administrator plays a key role in monitoring regulatory change, performing impact assessments, supporting audits and examinations, and advising business partners to ensure compliance with applicable requirements issued by regulatory and oversight agencies, including but not limited to the Centers for Medicare & Medicaid Services (CMS), New York State Department of Health (DOH), Department of Financial Services (DFS), Department of Labor (DOL), Office of Inspector General (OIG), and Office of...

Job Description: Summary: The Enterprise Regulatory Compliance Program Administrator evaluates new and evolving federal and state regulatory guidance and assesses their impact on enterprise-wide business processes, products, and operational strategies. This role partners closely with functional business areas to translate complex regulatory guidance into practical risk-based compliance solutions and supports the ongoing administration of an effective regulatory compliance program. The Administrator plays a key role in monitoring regulatory change, performing impact assessments, supporting audits and examinations, and advising business partners to ensure compliance with applicable requirements issued by regulatory and oversight agencies, including but not limited to the Centers for Medicare & Medicaid Services (CMS), New York State Department of Health (DOH), Department of Financial Services (DFS), Department of Labor (DOL), Office of Inspector General (OIG), and Office of...

Job Description: Summary: The Enterprise Regulatory Compliance Program Administrator evaluates new and evolving federal and state regulatory guidance and assesses their impact on enterprise-wide business processes, products, and operational strategies. This role partners closely with functional business areas to translate complex regulatory guidance into practical risk-based compliance solutions and supports the ongoing administration of an effective regulatory compliance program. The Administrator plays a key role in monitoring regulatory change, performing impact assessments, supporting audits and examinations, and advising business partners to ensure compliance with applicable requirements issued by regulatory and oversight agencies, including but not limited to the Centers for Medicare & Medicaid Services (CMS), New York State Department of Health (DOH), Department of Financial Services (DFS), Department of Labor (DOL), Office of Inspector General (OIG), and Office of...

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 treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential...

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 treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential...