- Highmark Health (Albany, NY)
- …Inc. **Job Description :** **JOB SUMMARY** This job is responsible for supervising member service call center and ensuring timely, professional, and courteous ... to other areas as necessary for resolution. Investigate escalated member inquiries. The incumbent may be required to make...routine medical approval decisions. **This role sits within the Medicaid Market - looking for someone who has Customer… more
- Children's Home of Wyoming Conference (Seneca Falls, NY)
- …comprehensive Social Care Navigator (SCN) services , including screening & navigation services to eligible Medicaid Members via phone, in-person, & virtually. ... initial screening identifies unmet HRSN needs. + Connect eligible Medicaid Members to services , care providers, &...Ensure Closed Loop Referrals by following up with eligible Medicaid Members within five business days after service… more
- Westchester Jewish Community Services (White Plains, NY)
- …has grown to be the largest provider of licensed outpatient community mental health services and one of the largest human service agencies in Westchester County. ... Overview: Westchester Jewish Community Services (WJCS), a non-profit organization, was founded in...of all ages and backgrounds each year. The A/R Supervisor is responsible for planning and implementing the daily,… more
- LIFEPlan CCO NY (Middletown, NY)
- …Description + Management of Care Managers + Provides supervision of service delivery and record keeping (per regulations and LIFEPlan's policies, procedures, ... agencies in order to address concerns and/or further develop or enhance LIFEPlan services . + Manages the performance of all assigned staff by continuous and regular… more
- Catholic Health Services (West Islip, NY)
- …Nursing & Rehabilitation has received five stars from Centers for Medicare & Medicaid Services (CMS) for quality measures. Job Details Maintenance Supervisor ... Overview Good Samaritan Nursing & Rehabilitation in Sayville, NY, is a member of the Catholic Health system. Our dedicated team has maintained a commitment to… more
- Centene Corporation (New York, NY)
- …and related CMS or state regulatory filings. + Understanding of Medicaid /Medicare payment structures, premium groups, regions, category-of- service mapping, and ... accuracy of reporting. + **Healthcare Managed Care :** + Understanding of Medicaid managed care, MLTC, MAP, Medicare Advantage, and cost-sharing arrangements. +… more
- Rochester Regional Health (Rochester, NY)
- SUMMARY Provides staff supervision related to assigned areas of responsibility. Supervisor , Social Work, works closely with Department /Practice Managers to ensure ... and ability to work various software applications. + Experience in the Medicaid eligibility determination and enrollment process. + Five years' experience in… more
- Molina Healthcare (Rochester, NY)
- …to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. * Ensures that adequate staffing coverage is ... optimization of medication related health care outcomes, and quality cost-effective member care. **Essential Job Duties** * Hires, trains, develops, and supervises… more
- Bowery Residents Committee (Bronx, NY)
- …with development and implementation of program goals and objectives to deliver services to mentally ill clients. Manage daily operations, monitor, schedule and ... restoring hope and dignity. Each and every BRC staff member makes heroic contributions to our city, providing vital... makes heroic contributions to our city, providing vital services in times of crisis and need. Through our… more
- Healthfirst (NY)
- …participant. + Monitor Medicaid re-certification time frames for each active Medicaid member . + Ensure Human Resource Administration and/or Department of ... eligibility, exclusion, and exemption codes. + Consult with HRA Medicaid staff as needed and report to supervisor...school diploma or GED from an accredited institution + Member facing or customer service experience +… more