- CVS Health (Albany, NY)
- …Special Needs Plan (DSNP) members, who are enrolled in both Medicare and Medicaid and face a variety of complex health and social challenges. Through compassionate ... all necessary care covered by their benefit plans and available through Medicaid and community resources. . Build relationships with hospital social workers and… more
- EPI (Rochester, NY)
- …Purpose: The primary function of this role is to ensure quality and Medicaid Compliance standards are met, through verification of all completed Office for People ... Action Plans/ Service Plans, Life Plans/Plans of Care, Level of Care Eligibility Determination (LCED), etc., and assures all record keeping and documentation… more
- EPI (Rochester, NY)
- …Residential programs, established by providers and to ensure quality and Medicaid Compliance standards are met, through verification of all completed Office ... Plan (IPOP), Plan of Nursing (PONs), Level of Care Eligibility Determination (LCEDs), etc., and assures all record keeping...requirements are completed timely to meet billing, quality, and Medicaid Compliance standards. + Acts as a member of… more
- New York State Civil Service (Albany, NY)
- …budget development (eg, Budget Request and Executive Budget) and execution (eg, Medicaid State share transfers to DOH).* Updating OMH's spending plan guidelines ... provision of mental health services.* Coordinating journal vouchers for Medicaid transfers including tracking and supporting documentation.* Conducting periodic… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …On and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market - ... the Health Plan regions Essential Accountabilities: Level I * Educates Medicaid , Medicare, and Commercial members on healthcare benefits, and community resources… more
- EPI (Rochester, NY)
- …Purpose: The primary function of this role is to ensure quality and Medicaid Compliance standards are met, through verification of all completed Office for People ... Action Plans/ Service Plans, Life Plans/Plans of Care, Level of Care Eligibility Determination (LCED), etc., and assures all record keeping and documentation… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title Program Research Specialist 1/Trainee 1/Trainee 2 Occupational Category Other Professional ... time of interview. Additional Comments The Office of the Medicaid Inspector General is proud to be an equal...the minimum qualification requirements for this title, and a copy of your official transcript(s) in order to verify eligibility… more
- Cognizant (Albany, NY)
- …features. . Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and ... government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other...processes for individual, group, and government-sponsored health plans (Medicare, Medicaid , ACA). . Strong understanding of CMS, ACA, and… more
- CVS Health (Albany, NY)
- …practice experience. Two (2) + years of experience in managed care (Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS or AOA recognized specialty is ... we have an Integrated plan. Experience with managed care (Medicare and Medicaid ) utilization review preferred. **Education** MD (Doctor of Medicine) or DO (Doctor… more
- The Wesley Community (Saratoga Springs, NY)
- …members to resolve billing-related concerns. + Ensure compliance with Medicare/ Medicaid billing requirements, regulatory standards, and facility specific protocols. ... 2+ years of billing procedures for all payer types including Medicare, NY Medicaid , HMO and Private insurance + Experience with Private Pay collections + Experience… more