- Northern Rivers Family Services (Albany, NY)
- …tasks assigned by CFO, Controller, Director of Revenue Cycle Management or AR Manager based on workload. You will report to the Chief Financial Officer, until ... for which provide billable services or are required to register with Medicaid/ Medicare based on their credential, department and position. + Work with organizational… more
- Molina Healthcare (Albany, NY)
- …appropriate and correct clinical decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
- CenterWell (Albany, NY)
- …+ Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years clinical experience ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Mount Sinai Health System (New York, NY)
- …direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access ... procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health care… more
- Premier Medical Group of the Hudson Valley (Poughkeepsie, NY)
- …(Hourly) LOCATION: 696 Dutchess Turnpike, Poughkeepsie, NY 12603 REPORTS TO: Manager , Care Coordination SHIFT/CORE HOURS: Monday-Friday 8:30 AM-5:00 PM POSITION ... to detail, and exercise professional work ethics. + Familiarity with applicable Medicare and Medicaid programs preferred. + Understanding of HIPAA, Privacy, Safety,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and community events. Essential Accountabilities: Level I * Educates Medicaid, Medicare , and Commercial members on healthcare benefits, and community resources ... needs, and other high-risk issues. * Conducts targeted phone calls for compliance , HEDIS initiatives and health risk assessments. * Collaborate with Case Management… more
- Catholic Health Services (West Islip, NY)
- …Coordination department, Medical Staff, and SCSH Administrative Staff. Ensures compliance with Hospital Conditions of Participation. Implements care management ... is required. Current knowledge of NY Department of Health and Centers of Medicare and Medicaid regulations is required. Knowledge of Joint Commission Standards, and… more
- CVS Health (Albany, NY)
- …impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... in the care planning process in collaboration with the Care Manager , to include the following actions: assessment, goal setting, establishing interventions… more
- CenterWell (Hauppauge, NY)
- …the HHA Registry (if applicable) and have completed HHA/CNA course to work for a Medicare certified agency. + At least one year experience in the last 24 months as ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- CenterWell (Hauppauge, NY)
- …the HHA Registry (if applicable) and have completed HHA/CNA course to work for a Medicare certified agency. + At least one year experience in the last 24 months as ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more