- The Arc Erie County NY (Buffalo, NY)
- …agency, the Office for People With Developmental Disabilities OPWDD, Medicaid , Medicare, insurance companies, municipalities, Department of Health, school districts, ... Receives direct supervision from the Coordinator of Speech Therapy and/or Associate Director of Clinical Services. Provides guidance and instruction to support staff… more
- Erie 2-Chautauqua-Cattaraugus BOCES (Williamsville, NY)
- …agency, the Office for People With Developmental Disabilities OPWDD, Medicaid , Medicare, insurance companies, municipalities, Department of Health, school districts, ... Receives direct supervision from the Coordinator of Speech Therapy and/or Associate Director of Clinical Services. Provides guidance and instruction to support staff… more
- Humana (Albany, NY)
- …of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid , and other health plans to millions. By integrating insurance with care ... plays a pivotal role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of the company's total revenue and earnings.… more
- Callen-Lorde Community Health Center (New York, NY)
- …Job Location(s) Callen-Lorde Community Health Center - Manhattan - New York, NY Remote Type Hybrid Position Type Full Time Education Level High School Salary Range ... health issues. About the Role TheManager of Billingworks directly with the Director of Billing Operations to oversee all billing, reconciliation, and collections for… more
- Humana (Albany, NY)
- …mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental requirements for ... revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of healthcare records +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …to governmental agencies (eg APS/CPS) as needed, and any suspected/possible Medicaid fraud to the Special Investigations Unit (SIU) or designated internal/external ... and ensures all regulatory requirements such as DOH, CMS, Medicaid , and accreditation requirements such as NCQA, URAC and...May be required to attend Fair Hearings with Medical Director relating to specific cases. + Works independently, as… more
- University of Rochester (Albany, NY)
- …to all and is a place where all can thrive. **Job Location (Full Address):** Remote Work - New York, Albany, New York, United States of America, 12224 **Opening:** ... including but not limited to, The Joint Commission TJC, Center for Medicaid and Medicare Services (CMS), National Committee for Quality Assurance (NCQA), State… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …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 ... and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and providers to obtain… more
- HCR Home Care (Rochester, NY)
- …care in the home to HCR patients. Th is position may be remote , with appropriate approvals , and provides service, coordination, management during afterhours and ... new interim orders before they are sent to physician. Notify Clinical Manager/Regional Director if unable to approve the order. + Assure orders are written according… more
- Humana (Albany, NY)
- …work closely with established functions inside utilization management (Medical Director , clinician decision making teams, quality audits, prior authorization list ... your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be… more