- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …with federal and state regulations and company policy and procedures. Acts as in-house case manager by considering all aspects of the residents care and ... that govern the process + Acts as an in-house Case Manager demonstrating detailed knowledge of residents...understanding of MDS requirements related to varied payers including Medicare , Managed Care and Medicaid + Ensures timely electronic… more
- Molina Healthcare (Syracuse, NY)
- …that involve clinical HCS staff. Communicates findings to the Supervisor or Manager , HCS Department for resolution. + Maintains a minimal caseload as determined ... guidelines and support staff who have an ongoing member case load for regular outreach and management. + As...staff workload for adherence to the Policies, Procedures, Guidelines, Medicare Model of Care, and deadlines. Assures oversight and… more
- Mount Sinai Health System (New York, NY)
- …direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access ... procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health care… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and community events. Essential Accountabilities: Level I * Educates Medicaid, Medicare , and Commercial members on healthcare benefits, and community resources ... home visits and outreach. * Educates and assists members with accessing care, Case Management program and benefits and government cell phone programs. * Coordinates,… more
- HCR Home Care (Rochester, NY)
- …normality . Review new lab order via fax and email clinician to review and n otify case manager and physician , as appropriate . + En try of Hospital Hold ... all new interim orders before they are sent to physician. Notify Clinical Manager /Regional Director if unable to approve the order. + Assure orders are written… more
- Molina Healthcare (Albany, NY)
- …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
- BAYADA Home Health Care (Delhi, NY)
- **At Home Care, Inc. is a Medicare certified home health agency with a 4 STAR Rating for quality and patient satisfaction!** **At Home Care, Inc.** is looking for ... + Monitor clients' conditions, reporting changes to Clinical or Client Services Manager . + Follow up with, execute, and properly document doctors' orders. +… more
- Highmark Health (Albany, NY)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs...related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges… more
- Trinity Health (Albany, NY)
- …visitors, vendors, various regulatory and professional agencies. **SUPERVISED BY:** Manager of Risk Management **SUPERVISES:** none **CAREER PATH:** Management ... the Department of Health as required by law. **_Specific Activities_** + Conducts case finding by daily review of reported events and other information retrieved… more
- Albany Medical Center (Albany, NY)
- …and hospital clinical leadership, legal, compliance, billing, finance, IT, case and utilization management, quality, credentialing, and other related departments. ... value-based enterprise financial acumen + Demonstrated leader of people and manager of resources. + Demonstrated success in orchestrating, leading, and overseeing… more