- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. ** Medicaid Program Manager in Albany, NY** **Division of Data Services & Analytics ... (BEDG) is seeking a strategic, action-oriented Data Policy Program Manager to lead the development, documentation, communication, and operationalization of… more
- Humana (Albany, NY)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- CVS Health (Albany, NY)
- …Member Services teams, as well as management of tools, etc. Ensure compliance with state mandated processes and procedures by maintaining contractual oversight of ... projects based on resource requirements. **Required Qualifications** Strong knowledge of Medicaid to include experience with the Member Call Centers Experience with… more
- CenterWell (Albany, NY)
- …a part of our caring community and help us put health first** The Medicaid Drug Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care, ... drug strategies to mitigate cost trend and improve health outcomes. The Medicaid Drug Strategy Pharmacist Lead work assignments involve moderately complex to complex… more
- Project Renewal, Inc. (New York, NY)
- Title: Senior Manager , Compliance Program: Legal, Varick Headquarters Salary Range: $90,000 - $100,000 per year Overall Responsibilities: The Senior Manager , ... in healthcare and related human services. The Senior Manager , Compliance reports to the Director of...state, and local healthcare regulations (eg, HIPAA, Stark Law, Medicaid /Medicare, Part 2). + Ensure the organization's compliance… more
- YAI (Manhattan, NY)
- …but not limited to State regulatory agencies (OPWDD, Centers for Medicare and Medicaid Services (CMS), Office of Medicaid Inspector General (OMIG), Department of ... annual OPWDD DQI and OFPC surveys. + Supports regional leadership with identifying compliance risks, completing an annual risk assessment, and developing an annual … more
- Molina Healthcare (Albany, NY)
- …should be knowledgeable of and have experience with South Carolina Medicaid **Job Summary** Provides subject matter expertise and responsibility for oversight, ... goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits &… more
- CVS Health (Albany, NY)
- …accreditation from the National Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance , Medicaid Investigations, MCO Medicaid FWA ... Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role...Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and written communication skills.… more
- Molina Healthcare (Rochester, NY)
- …goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits & ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… 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