- Two95 International Inc. (New York, NY)
- …data analysis (including EMR/EHR, claims, eligibility and publicly available data such as CMS LDS) * Utilization of analytical tools including SQL, SAS, SPSS, and/or ... R, or similar * Deep familiarity with HEDIS & CMS care quality measures; experience implementing both HEDIS and...contribute to areas such as infrastructure, administration, and project management with ease * Handy with Tools: Working knowledge… more
- Humana (Albany, NY)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual ... by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts.… more
- CVS Health (Albany, NY)
- …codes that are submitted to the Centers for Medicare and Medicaid Services ( CMS ) for the purpose of risk adjustment processes are appropriate, accurate, and ... process audits to ensure compliance with internal policies and procedures and existing CMS regulations. + Ability to work independently as well as in a cross… more
- City of New York (New York, NY)
- …school. - Meet with the school principals to follow up on issues regarding the CMs work. - Maintain weekly case management reports. - Maintain case management ... services to Department of Education students. The Asthma Case Management Program (ACMP) is a component of the Office...in the program and be cross trained for all CMs in the program. - Supervise the asthma case… more
- Humana (New York, NY)
- …Bachelor's degree + 10 plus years' experience in health insurance operations, complaint management , and CMS STARs programs (experience in large national insurers ... serve as a strategic leader overseeing initiatives to improve CMS STAR ratings and manage Complaint Tracking Metrics (CTMs)...annual revenue. + Collaborate with peer leaders in Risk Management and Grievances & Appeals to implement best practices… more
- Elevance Health (East Syracuse, NY)
- …position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of ... : + Degree in Accounting preferred. + Knowledge of CMS program regulations and cost report format preferred. +...regulations and cost report format preferred. + Knowledge of CMS computer systems and Microsoft Office Word and Excel… more
- Pearl Interactive Network (Albany, NY)
- …GovWin, FedBizOpps (FBO), Federal Procurement Data System (FPDS), and the System for Award Management (SAM). + Strong leadership skills with experience ... Develop and refine a 3-year growth roadmap covering target federal agencies ( CMS , VA, HHS, SSA, DOD), state agencies (including Medicaid/Exchange programs) and… more
- New York Racing Association (NY)
- …from the Creative Team. + Plan, implement, and maintain daily website content via CMS (Wagtail). Responsible for publishing editorial, building promotional ... and analyze effectiveness. This position will also oversee digital analytics and content development for relevant properties. This person will also manage the… more
- Datavant (Albany, NY)
- …combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be accountable for ensuring our products deliver ... customer outcomes, regulatory drivers, and market trends in risk adjustment, care management , and provider enablement. + Identify and prioritize use cases that… more
- Humana (Albany, NY)
- …by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from inpatient or post-acute care… more