- Deloitte (New York, NY)
- …consulting services to public sector clients Support engagements focused on Medicaid reimbursement, including actuarial rate development across managed care and ... fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...health plan/insurance company experience 2+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate… more
- Humana (Albany, NY)
- …caring community and help us put health first Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness ... in identification of cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. The Actuary, Analytics/Forecasting ensures data integrity by… more
- Novo Nordisk Inc. (Buffalo, NY)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... Coverage Gap, Copays, and Deductibles and the impact on customer decisions Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to identify business opportunities… more
- Lundbeck (Schenectady, NY)
- …and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - Ability ... to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. REQUIRED EDUCATION, EXPERIENCE and… more
- Lundbeck (Binghamton, NY)
- …anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - Apply ... knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. REQUIRED EDUCATION, EXPERIENCE and SKILLS:… more
- Molina Healthcare (Peekskill, NY)
- …screens potentially eligible recipients for enrollment into Government Programs such as Medicaid / Medicaid Managed Care, Child Health Plus and Essential Plan. ... screen and assist potentially eligible recipients with the enrollment process into Medicaid / Medicaid Managed Care, Child Health Plus the Essential Plan and… more
- Robert Half (Rochester, NY)
- …of legal processes and client services within business law, estate planning, Medicaid planning, and real estate practice areas. Location: Rochester, NY Role: Legal ... closing documentation, and liaise with title companies Assist with Medicaid application preparation and documentation gathering Maintain accurate timekeeping records… more
- Molina Healthcare (Yonkers, NY)
- …and requirements established by the Centers for Medicare and Medicaid KNOWLEDGE/SKILLS/ABILITIES Responsible for the comprehensive research and resolution of ... coordination of benefits, subrogation, and eligibility criteria. Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge… more
- MVP Health Care (Schenectady, NY)
- …performing analytics and reporting on Medicare, Commercial Exchange, and Medicaid /HARP member populations. Provideanalytical support on various prospective and ... Risk Group (CRG) software to target interventions for improved coding for Medicaid members. Calculates ROIs for Risk Adjustment programs. Maintain regulatory agency… more
- Molina Healthcare (Buffalo, NY)
- …processing and configuration works Medicare fee schedule knowledge is required Medicaid and Duals experience is highly preferred JOB QUALIFICATIONS Required ... claims payment method. Preferred Education Graduate Degree or equivalent experience Medicaid and Duals expeirence is preferred. Preferred Experience 7-9 years To… more
