- Living Resources (Albany, NY)
- Community Living Case Manager (QIDP)/Intake Coordinator Albany, NY (http://maps.google.com/maps?q=Albany+NY+USA+12203) Job Type Full-time Description Living ... as needed, and maintain familiarity with both internal and external requirements for compliance . + Participate in agency and program training as it relates to tasks… more
- Centers Plan for Healthy Living (Brooklyn, NY)
- …need for healthy living. JOB SUMMARY : The Licensed Benefits Advisor- Medicare Sales, Maintains relationships, services our existing customers and secures new ... and performing all required tasks assigned by the Sales Manager . Incumbent will be responsible for educating and enrolling...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation ... specific health plan benefits, and efficient care delivery processes. Ensures compliance with corporate and departmental policy and procedure, identifies and refers… more
- CVS Health (Albany, NY)
- …issues. + Manages operational aspects of the team (eg, budget, performance, and compliance ), and implements workforce and succession plans to meet business needs. + ... of 3 years managing/leading a team. + Experience working in Medicare , Medicaid, or Commercial Health Insurance. **Preferred Qualifications** + Experience working… more
- Healthfirst (NY)
- …implementing statistics and process control tools; and maintaining effective compliance and corrective action procedures. + Demonstrated knowledge in creating ... + Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family + Experience managing… more
- Northwell Health (Staten Island, NY)
- …and post-discharge eligibility in relation to clinical course. + Ensures compliance with current state, federal, and third party payer regulations. + ... companies and physicians regarding utilization issues. + Utilizes important message from Medicare (IMM) when appropriate. + Ensures managed care reviews are up to… more
- Molina Healthcare (Syracuse, NY)
- …and supervision of daily functional operations to insure compliance to contract requirements. **Knowledge/Skills/Abilities** * Oversees budget responsibilities ... type management responsibility. 5 years progressive experience supporting a Medicaid,. Medicare and Marketplace or large claims processing environment with… more
- Calvary Hospital (Bronx, NY)
- …continued Medicare /Medicaid Recertification's. + Prepare statistical reports for Corporate Compliance Regulations @ Home and QA & I. + Maintain overall ... supervision of discharge medical record completion prior to final filing. + Performs other related duties as assigned. Requirements Qualifications: + Current NYS RN License + Current Driver's License. + Baccalaureate Degree in Nursing from an accredited school… more
- Humana (Albany, NY)
- …and other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the ... in special projects as assigned by your Supervisor or Manager . **Use your skills to make an impact** Additional...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years.… more
- Molina Healthcare (Yonkers, NY)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more