• Director, System Payer Contracting (On-site)

    Albany Medical Center (Albany, NY)
    …relationships. + Demonstrated knowledge of current federal and NYS regulations regarding managed care contracting, as well as the provision and reimbursement ... and hospital clinical leadership, legal, compliance, billing, finance, IT, case and utilization management, quality, credentialing, and other related departments.… more
    Albany Medical Center (07/16/25)
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  • Medicaid Eligibility Specialist

    City of New York (New York, NY)
    …with activities of daily living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the Assisted Living Program, ... AVAILABLE TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT. The Home Care Services Program (HCSP) is a Medicaid funded program...and Federal guidelines and procedures. - Complete the required case action utilizing the Welfare Management System (WMS) and… more
    City of New York (05/14/25)
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  • Legal Nurse/Medical Analyst: Medicaid Fraud…

    New York State Civil Service (Albany, NY)
    …as quality assurance issues; * Case management, MDS 3.0 Resident Assessment, and/or managed care ; * Prior experience as a legal nurse consultant; and * ... reports of abuse and neglect in nursing homes and other residential health care facilities in the state. Possessing both civil and criminal enforcement powers, MFCU… more
    New York State Civil Service (06/13/25)
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  • Legal Nurse/Medical Analyst:Medicaid Fraud Control…

    New York State Civil Service (New York, NY)
    …as quality assurance issues; * Case management, MDS 3.0 Resident Assessment, and/or managed care ; * Prior experience as a legal nurse consultant; and * ... reports of abuse and neglect in nursing homes and other residential health care facilities in the state. Possessing both civil and criminal enforcement powers, MFCU… more
    New York State Civil Service (05/14/25)
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  • Substance Abuse Floor Counselor

    Outreach Development Corporation (Brentwood, NY)
    …relationships with referents and other collateral contacts (ie, Probation, Parole, CPS, managed care , EAP's, courts, etc.) through timely written, phone, ... Job Scope: + Conducts assessments, intakes and participates in level of care determinations by gathering appropriate data, orienting client to his/her rights and… more
    Outreach Development Corporation (07/24/25)
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  • Translator, Language, SMH - Spanish

    University of Rochester (Rochester, NY)
    …satisfaction - Informs patients of available supports as appropriate (Social Worker, Case Manager , Care Coordinator, Financial Coordinator, Chaplain, etc.) ... Improving Access to Services for Persons with Limited English Proficiency, Medicaid Managed Care Requirements (42 CFR 438.10) The US Department of Health and… more
    University of Rochester (06/16/25)
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  • Interpreter, Language, SMH

    University of Rochester (Rochester, NY)
    …satisfaction + Informs patients of available supports as appropriate (Social Worker, Case Manager , Care Coordinator, Financial Coordinator, Chaplain, etc.) ... Improving Access to Services for Persons with Limited English Proficiency, Medicaid Managed Care Requirements (42 CFR 438.10) The US Department of Health and… more
    University of Rochester (07/19/25)
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  • Spanish Interpreter

    University of Rochester (Rochester, NY)
    …satisfaction - Informs patients of available supports as appropriate (Social Worker, Case Manager , Care Coordinator, Financial Coordinator, Chaplain, etc.) ... Improving Access to Services for Persons with Limited English Proficiency, Medicaid Managed Care Requirements (42 CFR 438.10) The US Department of Health and… more
    University of Rochester (06/16/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (NY)
    …preferred. **Required Experience** + 3-5 years clinical nursing experience, with 1-3 years Managed Care Experience in the specific programs supported by the plan ... of service provided, length of stay and level of care . + Applies appropriate criteria on PAR and Non-PAR...Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management… more
    Molina Healthcare (07/20/25)
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  • Compensation Claims Referee (NY Helps), Wcb Item

    New York State Civil Service (New York, NY)
    …the Board has approved an application for rehearing or reopening or restored the case to the calendar for any other reason.* Receives and analyzes evidence of the ... Please Note: A hybrid telecommuting schedule can be discussed with the hiring manager during the interview.We offer a work-life balance and a generous benefits… more
    New York State Civil Service (07/29/25)
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