- Humana (Albany, NY)
- …The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana's largest, which comprises over 80% of the company's total ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- New York State Civil Service (NY)
- …Labor as well as coordination with federal government Center for Medicare and Medicaid services (CMS).* Provide occasional work in the New York State Emergency ... eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility. * If… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …coding, Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding, and Medicaid Clinical Risk Groups (CRGs) to ensure compliance. * Assist in ... CPT, HCPC) * Familiarity and understanding of CMS HCC Risk Adjustment coding, Medicaid CRG coding, and data validation requirements, preferred. * Strong written and… more
- New York State Civil Service (Queens Village, NY)
- …and maintain eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain Medicaid /Medicare eligibility ... will result in the termination of employment. Additional Comments Background Investigation Requirements: Prospective appointees will be: 1) Checked against the Staff Exclusion List (SEL) maintained by the Justice Center for the Protection of People with… more
- Humana (Albany, NY)
- …residence + Eligibility to participate in federal prescription programs (eg, Medicare/ Medicaid ) + Self-directed with the ability to work effectively both ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Centene Corporation (Queens, NY)
- …Health (CDOH), Local Department of Social Services and Center for Medicare & Medicaid Services (CMS). The Clinical Quality Assurance RN will also create, analyze, ... Health (DOH) and Local Department of Social Services and Center for Medicare & Medicaid Services (CMS regulations). Working in a home care environment or as a staff… more
- Cardinal McCloskey Community Services (Valhalla, NY)
- …Care Network Screener/Navigator, where you'll play a vital role in connecting Medicaid participants to essential services that address their social determinants of ... Responsibilities: + Conduct comprehensive screenings and eligibility assessments for Medicaid participants. + Develop and maintain personalized care plans that… more
- Elevance Health (East Syracuse, NY)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
- AHRC Suffolk (Bohemia, NY)
- …about any emergencies or sensitive situations. Completes and submits annual Medicaid Recertification and resolves issues affecting an individual's Medicaid ... /Medicare/private insurance. Assists, as needed, in the management of behavior and emergency care. Participates in State Audits Handles all daily and monthly paperwork for the house, including medical and billing, within the required deadlines in adherence to… more
- Humana (Albany, NY)
- …clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Must be passionate about contributing to ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more