• Program Research Specialist 2 (Economics…

    New York State Civil Service (New York, NY)
    …Services, Department of Title Program Research Specialist 2 (Economics Finance ), SG-23 Occupational Category Financial, Accounting, Auditing Salary Grade 23 ... is seeking candidates for the position of Program Research Specialist 2 (Economic Finance ) in the Consumer Examinations Unit. Duties include, but are not limited to,… more
    New York State Civil Service (07/15/25)
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  • Contract Agency Finance Specialist

    City of New York (New York, NY)
    …one (1) Principal Administrative Associate II to function as the Contract Agency Finance Specialist, who will: - Review and process programmatic submissions of DSP ... documents. - Perform weekly actions to ensure that New York City's share of Medicaid funding is paid through the New York State MMIS system including performing… more
    City of New York (07/18/25)
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  • Formulary and Medical Strategies Senior…

    Humana (Albany, NY)
    …and other business functions to implement formulary and medical strategies for the Medicaid line of business. Makes decisions on moderately complex to complex issues ... other business functions to implement formulary and medical strategies for the Medicaid line of business. + Utilizes broad understanding of pharmacy, managed care,… more
    Humana (08/20/25)
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  • Section Manager

    City of New York (New York, NY)
    …The Medical Assistance Program (MAP) administers public health insurance programs, including Medicaid , for the City of New York. Applying individuals and families ... other health care services at little or no cost. Medicaid Reimbursement Unit under the general direction of the...payments. - Forward invoices to the HRA Office of Finance for payment in a timely manner to avoid… more
    City of New York (08/13/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Yonkers, NY)
    …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... oversight. + Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.… more
    Molina Healthcare (08/20/25)
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  • Audit Reviewer

    City of New York (New York, NY)
    Job Description The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to medically fragile and vulnerable individuals who ... Care (MLTC) Program, the Assisted Living Program, Care at Home Program and Homebound Medicaid . The Medicaid Eligibility Unit is responsible for the Medicaid more
    City of New York (08/13/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (Albany, NY)
    …oversight. + Collaborate with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies. ... requirements, workflows, and solutions that drive measurable improvement. + Partner with finance and compliance to develop business cases and support reporting that… more
    Molina Healthcare (08/14/25)
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  • Senior Encounter Data Management Professional

    Humana (Albany, NY)
    …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looking for long-term improvements of encounter submission processes. Begins to… more
    Humana (08/15/25)
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  • Executive Director, Data Analytics & Verification

    City of New York (New York, NY)
    …program eligibility. Additionally, designing and operating analytics processes to identify Medicaid savings, both within DSS and State Department of Health (SDOH), ... directly saving hundreds of millions of dollars in annual Medicaid spending. This work includes identifying Medicaid clients who should apply for Medicare,… more
    City of New York (08/13/25)
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  • Executive Director Of Fields Operations

    City of New York (New York, NY)
    …process applications including screening, intake, and assessment and monitoring of Medicaid eligibility and all related community alternative health care services, ... direction of the personnel engaged in processing applications, monitoring Medicaid eligibility and conducting eligibility assessments for community alternative… more
    City of New York (08/13/25)
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