- Molina Healthcare (Yonkers, NY)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met...that drive measurable improvement. + Partners with finance and compliance to develop business cases and support reporting that… more
- LIFEPlan CCO NY (Utica, NY)
- …people with intellectual or developmental disabilities. + Related experience, specifically as a Medicaid Service Coordination or Care Manager is preferred + Must ... $30.00 Hourly Description Job Summary: The Care Connection Specialist/Care Manager , as a member of the Care Connection team,...+ Provide support to ensure the correct type of Medicaid is secured to receive OPWDD eligible services. This… more
- Springbrook (Oneonta, NY)
- …compliance issues + Responsible for internal auditing of all programs receiving Medicaid Services (to ensure compliance with Medicaid regulatory ... requirements). + Responsible for internal auditing of non- Medicaid services to ensure compliance with OPWDD,...documents as needed or any other duties assigned by manager . + All other duties as assigned. Qualifications, Skills… more
- Access: Supports For Living (Middletown, NY)
- …per hour Hours: Monday-Friday 8:00AM-4:30PM (40hrs) Job Description: Reporting to the A/R Manager , the Senior Billing Specialist is a key position in the financial ... + Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid , Medicaid Managed Care and other payers'...remain updated with current coding and billing regulations and compliance requirements + Oversight of self-pay processing and assist… more
- Planned Parenthood of Central and Western NY (Buffalo, NY)
- …relative to the evaluation, processing, and handling of Presumptive Medicaid (PEP/MAPE), Presumptive Eligibility Family Planning Benefit Program (PEFPBP), and ... health center staff on enrollment processes in collaboration with the Health Center Manager and Revenue Cycle Trainer + Implements new programs or existing programs… more
- Humana (Albany, NY)
- …other vendors. + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails request for services the same day. ... in special projects as assigned by your Supervisor or Manager . **Use your skills to make an impact** **Required...to help people with Medicare, or both Medicare and Medicaid , achieve their best possible health and wellness through… more
- CenterWell (Albany, NY)
- …experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + ... degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Outreach Development Corporation (Brentwood, NY)
- …Exercise due diligence in the delivery of quality care in line with agency Medicaid Compliance Plan and systems of accountability. + Insure communication through ... officer and/or the supervisory structure of any violation of non- compliance with the agency's Medicaid compliance...discussion point in the annual evaluation. Supervised by House Manager , Asst. House Manager Qualifications + Experience… more
- City of New York (New York, NY)
- …of data source specific policies and standard operating procedures ensuring compliance with governance policies. - Oversee data stewardship and administration of ... New York State Department of Health (NYSDOH) Medicaid and hospital discharge data and NYS-Statewide Health Information...sharing procedures into DOHMH data sharing policies while maintaining compliance with data stewards DUAs. - Oversee the timely… more
- GMHC (New York, NY)
- …Intake Case Manager , Mental Health Counselor, and Substance Use Case Manager , perform their roles effectively in compliance with contractual obligations. ... programs to advance staff skills in areas such as client care, compliance with housing regulations, and effective communication techniques. + Promote a culture… more