- Humana (Albany, NY)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ... sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- CDPHP (Latham, NY)
- …in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and ... Acting as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit (SIU), Provider Relations (PR), or… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and ... Acting as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit (SIU), Provider Relations (PR), or… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and post- service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members' medical health conditions, ... + Acts as a resource and liaison to the provider community in conjunction with Provider Relations,...assignments; cross-trained to review various levels of care and/or services . + Participate in committees and lead … more
- Public Consulting Group (Albany, NY)
- …streamline operations and achieve strategic goals to serve the public better. We provide the full spectrum of technology consulting services to help state ... and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000… more
- Molina Healthcare (Buffalo, NY)
- … provider contracting experience. * Experience with NCQA, HEDIS, Medicaid , Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO ... and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs.… more
- Bassett Healthcare (Oneonta, NY)
- …What you'll do The Community Health Navigator I role provides quality care to Medicaid recipients eligible for Health Home services . In this role a Navigator ... required to follow policy and procedure set by the lead Health Home to ensure quality and service...quality according to the Bassett Health Home Policies. + Provide Core Care Management Services to assigned… more
- NTT DATA North America (Albany, NY)
- …The Senior Quality Assurance (QA) Analyst will work with the Continuing Medicaid Eligibility Modernization initiative team to establish and execute QA tasks for ... and compliance with fiscal responsibilities. Responsibilities of this role include: + Lead the establishment of QA processes and procedures to support the Continuing… more
- J&J Family of Companies (Garden City, NY)
- …Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), ... personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the… more
- J&J Family of Companies (New York, NY)
- …Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), ... personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the… more