- 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
- Healthfirst (NY)
- …+ Performs first level review of all marketing materials to ensure compliance with State and Federal guidelines. + Prepares and submits marketing materials ... Responsible for entering, maintaining, and monitoring identified projects in Logic Manager and coordinates within Regulatory Affairs team. + Communicates and… more
- Trinity Health (Albany, NY)
- …They work to improve documentation quality, identify coding discrepancies, and ensure compliance with regulations as well as supporting SPHPMA, IHANY and Trinity ... adjustment and payer value-based plan initiatives to support revenue and compliance standards in our provider group. **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:**… more
- CenterWell (Albany, NY)
- …delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- CenterWell (Albany, NY)
- …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... volunteer time off, paid parental and caregiver leave), short-term and long -term disability, life insurance and many other opportunities. Application Deadline:… more
- CenterWell (Albany, NY)
- …quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity ... quality and value drivers in full risk care delivery, ideally in Medicare /seniors + Demonstrated ability to work collaboratively with clinical and operational… more
- Mount Sinai Health System (New York, NY)
- …issues in an accurate and timely fashion. In collaboration with the Underpayment Team manager , the Senior CBO Appeals Analyst will work to further the CBO's goals of ... enhancing contract compliance by researching, analyzing, documenting, and reporting underpayment trends, payer updates, payer regulations, and provide feedback on… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …environment + Managed long term care knowledge + Medicaid knowledge + Medicare knowledge SCOPE INFORMATION # Direct Reports: Training and Development Manager ... living. JOB SUMMARY: The objective is to ensure ongoing compliance , provide support and training by monitoring the field...policies and procedures and job responsibilities of the account manager + Create and implement training materials and tools… more
- Whitney Young Health Center (Albany, NY)
- …policies, procedures, controls and reporting systems. Ensures legal and regulatory compliance for all accounting and financial reporting functions. Manages financial ... corporate, and other tax returns and related reports, and ensure ongoing compliance with applicable tax codes, rules and regulations. + Establishes best practices… more
- New York State Civil Service (Wassaic, NY)
- …technical assistance and administrative support to treatment teams to ensure compliance with state and federal guidelines* Identify needs of service recipients ... the supervision of staff, ensuring that training is adequate and meets compliance standards. * Complete minor notable incident investigations * Assist the DDPSIV… more