- MVP Health Care (Tarrytown, NY)
- …(EP), HARP, On-Exchange Qualified Health Plans (QHP), Off-Exchange Plans, and Medicare Advantage plans to individuals at Federally Qualified Health Centers (FQHCs), ... enrollment process and ensure that all field staff is following the NYSOH & CMS guidelines, as well as all corporate enrollment processes (SMART). + Conduct spot… more
- Molina Healthcare (Buffalo, NY)
- …and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services ( CMS ) regulations and guidelines of risk ... CPC credential **Preferred Education** Bachelor's Degree in Business Administration, Health Care Management o To all current Molina employees: If you are interested… more
- Rochester Regional Health (Rochester, NY)
- …Family Cottages, has achieved and maintained a five-star rating from the Centers for Medicare and Medicaid Services ( CMS ) since 2013. Only 10% of nursing homes ... in the country attain this five-star rating. Conveniently located on the Unity Hospital Campus, the Wegman Family Cottages have been serving elders in our community since 2010. Our mission is to provide quality care, independence, and a positive living… more
- Molina Healthcare (NY)
- …inquiries. + Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and MMP Required Reporting Technical Specifications. + Create and ... quarterly Key Performance Indicator (KPI) reports. + Support the management of the regulatory memo distribution process Ability to...notices of proposed rulemaking. + Manages user access to CMS . + Analyze data use critical thinking + Ability… more
- Wolters Kluwer (New York, NY)
- …market insights into actionable product requirements, collaborates closely with Engineering, Content , and go-to-market teams, and ensures that our solutions meet the ... long-term advocacy. **Cross-Functional Collaboration** * Coordinate with Engineering and Content teams to ensure product requirements are well understood,… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …for Healthy Living (CPHL) claims. Collaborates with other Health plan departments and Management to ensure claims are processed in accordance with Federal, State and ... monitoring their use and identifying any deficiencies. + Prepare summaries for management of quality review results, including basic analysis of identified trends. +… more
- Garnet Health (Middletown, NY)
- …of patient complaints and the resolution of grievance according to Center for Medicare & Medicaid Services ( CMS ) guidelines. The Patient Experience Assistant ... At Garnet Health, the Hudson Valley's leading integrated health system , you'll find the perfect balance of a satisfying...people we serve. If you're interested in a health system that's both growing and award-winning, serving a diverse… more
- Catholic Health (Cheektowaga, NY)
- …are current and compliant with applicable federal and state regulation and with CMS and AMA coding guidelines. The Director will be responsible to maintain coding ... auditors and coding vendors. Overall, the director will leverage project management skills, clinical knowledge, coding knowledge and understanding of regulatory… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level of ... Monitor observation and the application of the 2nd Midnight across payor types ( CMS regulation). + Perform concurrent review and escalation of cases not meeting… more
- Bassett Healthcare (Oneonta, NY)
- … (when appropriate). Adherence to established Conditions of Coverage for the Center for Medicare & Medicaid services ( CMS ) for End Stage Renal Disease (ESRD) ... dialysis clinics. Core Social Worker Functions (applies to all Social Workers) Participation in departmental rounds or team meetings as required Comprehensive bio-psychosocial assessment of patient Treatment planning to address issues identified in… more