- Molina Healthcare (Rochester, NY)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more
- Humana (Albany, NY)
- …develop engagement best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Molina Healthcare (Albany, NY)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more
- Humana (Albany, NY)
- …team. **Preferred Qualifications:** + Master's Degree + Knowledge of the Medicare Advantage market, products, regulations, and compliance standards **Additional ... of our caring community and help us put health first** The Field Marketing Manager is responsible for leading and managing a high-performing team focused on driving… more
- Humana (Albany, NY)
- …of the business there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare , Medicaid, and/or and Group ... community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies,...advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The… more
- Molina Healthcare (Buffalo, NY)
- …as needed + Primary point of contact for the internal partners, ie Medicare Administration, Compliance and Health Plan Operations. Coordinates and facilitates ... including goal setting and score card development + Monitors and enforces compliance with enterprise-wide processes and develops workflows for all staff to follow… more
- Molina Healthcare (Yonkers, NY)
- **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare , and ... to support efficient and compliant subrogation operations across Medicaid, Medicare , and Marketplace populations. + Collaborate with legal, claims, provider… more
- Molina Healthcare (Albany, NY)
- **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly capable ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more
- J&J Family of Companies (New York, NY)
- …New York, New York, United States **Job Description:** **Field Reimbursement Manager (Immunology Dermatology)- (** **Manhattan South, NY** **) - Johnson & ... Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the New York,… more
- Ellis Medicine (Schenectady, NY)
- SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management of assigned patients on a designated unit(s). This position works with the ... efficient quality care and achievement of desired treatment outcomes. The Case Manager confirms admission and continued stay are medically necessary and ensures the… more