Palladian Health operational departments are listed below with a brief description of their functions to assist you in identifying employment opportunities that are best suited to your experience, skills and interests.

Administration - Administrative staff provide clerical support for management personnel.

Claims - The Claims Department is responsible for the timely and accurate processing of all medical claims in line with Federal, State, and contractual requirements.

Document Preparation - The Document Preparation Department’s primary function is to batch, scan and review all of the incoming documents/forms from provider offices for proper imaging and system processing.

Call Center/Customer Service - The Call Center/Customer Service Department is responsible for handling inbound calls from health plan participants and medical service providers. Call Center/Customer Service Representatives work in a fast paced inbound/outbound call center environment, responding to telephone inquiries from health plan participants and medical service providers.

Clinical Services - The Clinical Services Department is responsible for reviewing requests and providing decisions pertaining to discipline-specific medical necessity of care. Medical & Physical Health Professionals (Medical Doctors, NYS Licensed Chiropractors, and NYS Licensed Physical Therapists) render determinations for care requests.

Finance - The Finance Department’s primary function is to properly and accurately administer and record all corporate financial transactions according to state, federal and contractual requirements.

Grievance & Appeal - G&A staff handle requests for the re-review of benefit and medical necessity decisions. G&A staff facilitates the collection of new information and coordinate communication between the member, all health care professionals involved in the member’s care, and the health plan to ensure appropriate and timely resolution.

Human Resource - The Human Resources Department is responsible for recruitment and selection of personnel, performance, conduct and behavior management, company and employee relations, staff/management training and development, as well as compensation, rewards and benefits management.

Information Technology - The Information Technology Department ensures consistency and state of the art development of information technology throughout Palladian Health. Information Systems Professionals are responsible for all aspects of software/website development, (clinical systems and technology improvement), systems administration (hardware, networking, and technical support), operations and daily processes, security, as well as reporting, data analysis and process improvement.

Network Management - The Network Management Department is responsible for the promotion and expansion of all specialty provider networks. Network Management Agents execute an intense provider recruitment campaign via outbound calling, email, mail and fax to maintain existing provider networks, and facilitate the provider credentialing process as required by regulatory and contractual standards.

Operations - The Operations Department’s primary function is to evaluate, design, manage, and implement processes that support the effective delivery of products and services.

Quality Assurance & Compliance - The Quality Assurance & Compliance Department (QA) is the primary conduit with health plan clients and regulatory bodies. QA staff performs audits and analyses of operations to ensure regulatory and contractual obligations are being met. Staff identify areas of risk and recommends measures to mitigate that risk. Staff enforce plans of correction where deficiencies are noted, and ensures attainment and maintenance of applicable corporate accreditations/licensure.

Palladian EAP - The Employee Assistance Program (EAP) is a confidential resource for all employees and their dependents to address personal or professional concerns that are negatively impacting their workplace performance. EAP Clinicians are responsible for triaging, assessing, and offering counseling services to address employees’ personal or professional issues that are impacting workplace performance. Clinicians also facilitate group trainings and workplace debriefings.

Product and Analytics - The Product and Analytics Department is responsible for development and execution of a go-to-market strategy for new business, collaborating with technology and clinical teams to design and implement new products, driving a standardized solution set across development teams, and providing clients with reporting, analytics, and consultation that is actionable and impactful.

Sales and Marketing - The Sales & Marketing department is responsible for developing programs and implementing strategies to generate new business. This includes leveraging relationships with prospective clients and expanding services to existing clients through a variety of channels.

Utilization Management – The Utilization Management (UM) Department receives and processes service authorization requests, ensuring that coverage is available and complete data is available for medical necessity, as well as appropriate and efficient use of health care services. The UM staff complete prescreening and data collection in compliance with time-sensitive regulatory requirements to make certain care is available without delay.