• Manager Enrollment and Billing

    Healthfirst (NY)
    …and terminations. + Collaborate with internal teams (eg, sales, customer service, compliance ) to ensure seamless management of members. + Monitor ,report, and ... ensures core Enrollment and Billing activities are managed in compliance with State and CMS guidelines and to ensure...of NY lines of business such as Medicare NY, Medicaid , Child Health Plus, QHP, EP, HARP + Bachelor's… more
    Healthfirst (06/10/25)
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  • RN Program Manager , Healthcare Services

    Molina Healthcare (Rochester, NY)
    …programs providing ongoing communication of goals, evaluation, and support to ensure compliance with standardized protocols and processes. + May engage and oversee ... years supervisory/management experience in a managed healthcare environment. + Medicaid /Medicare Population experience with increasing responsibility. + 3+ years of… more
    Molina Healthcare (08/21/25)
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  • Case Manager

    City of New York (New York, NY)
    …in the CAS Reasonable Accommodation Services unit, to function as a Case Manager , who will: - Handle the entire application process for all new applicants, ... for Public Assistance, Supplemental Nutrition Assistance Program (SNAP) and Medicaid . Elicit and record information concerning family composition, income, financial,… more
    City of New York (08/13/25)
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  • Substance Abuse Case Manager

    Albany Medical Center (Albany, NY)
    …States of America) Salary Range: $65,102.17 - $100,908.37 The Substance Abuse Case Manager provides Case Management services, as needed to patients under the care of ... and social security cards, help apply or reapply for Medicaid , and help navigate DSS (Department of Social Services)...the day prior to appointment as well to ensure compliance . + Travel between sites (Latham and Albany Medical… more
    Albany Medical Center (07/23/25)
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  • Specialty Care Manager

    Catholic Charities Family Community Services (Rochester, NY)
    **Specialty Care Manager ** **Job Details** **Level** Experienced **Job Location** 1099 Jay Street - Rochester, NY **Position Type** Full Time **Education Level** ... Assist clients in the acquisition and maintenance of public benefits eg, Medicaid , SNAP, Social Security, etc. + Provide linkage/referrals and coordination of… more
    Catholic Charities Family Community Services (06/06/25)
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  • Senior Credentialing Operations Manager

    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 in… more
    CVS Health (08/21/25)
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  • QA Audit Manager - Operations

    Healthfirst (NY)
    …implementing statistics and process control tools; and maintaining effective compliance and corrective action procedures. + Demonstrated knowledge in creating ... 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 a Quality… more
    Healthfirst (08/16/25)
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  • Manager , Operations -System Operations…

    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
    Molina Healthcare (07/31/25)
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  • Hospice Team Manager

    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
    Calvary Hospital (06/18/25)
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  • Lead Analyst, Configuration Oversight - Payment…

    Molina Healthcare (Syracuse, NY)
    …our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination of Benefits (COB) claim pricing and processing. This role ... will focus on identifying, reviewing, and validating Medicaid secondary payments to ensure alignment with internal configuration rules and regulatory guidance. The… more
    Molina Healthcare (07/24/25)
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