• Medical Investigator I/II

    Excellus BlueCross BlueShield (Rochester, NY)
    …+ Maintains accurate and up-to-date knowledge of all Government Programs regulations ( Medicaid , Medicare, Federal Employee Program , New York State Department of ... the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and coordination with the BCBS Association… more
    Excellus BlueCross BlueShield (09/17/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Rochester, NY)
    …with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other ... groups. + Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid , National Committee for Quality Assurance… more
    Molina Healthcare (09/20/25)
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  • Habilitation Specialist 1 - Hudson Valley

    New York State Civil Service (Millbrook, NY)
    …for reviewing and acknowledging life plans, maintaining contact with the care manager to ensure safety, values, and individual goals are maintained. Duties will ... response to DQI audits, regulations, and their roles in Medicaid Compliance.* Write, revise as needed and oversee implementation...the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). HELPS Program titles may… more
    New York State Civil Service (09/24/25)
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  • Senior Billing Specialist

    Access: Supports For Living (Middletown, NY)
    …per hour Hours: Monday-Friday 8:00AM-4:30PM (40hrs) Job Description: Reporting to the A/R Manager , the Senior Billing Specialist is a key position in the financial ... of weekly claims processing + Analyze, billing and processing program claims for accuracy and completeness; submit claims to...+ Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid , Medicaid Managed Care and other payers'… more
    Access: Supports For Living (09/04/25)
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  • Fair Hearing Service Specialist

    City of New York (New York, NY)
    …on-going support, resources and guidance for all new initiatives related FIA, Medicaid , Advocate Inquiry, Office of Administrative Hearing (OAI I), Office Program ... related to Agency decisions affecting receipt of Cash Assistance, SNAP and Medicaid benefits, and the preparation of documentation for presentation of evidence at… more
    City of New York (08/13/25)
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  • Social Care Network Coordinator

    The Salvation Army (Rome, NY)
    …OF POSITION:The SCC will have responsibilities for both managed care and program coordination for The Salvation Army's participation in the Social Care Network ... Waiver). The Social Care Coordinator is a direct point of contact for Medicaid Members with ongoing HRSNs (health-related social needs) and is responsible for… more
    The Salvation Army (08/29/25)
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  • Care Navigator

    Elderwood (Buffalo, NY)
    …year 401(k) retirement plan with vested employer match up to 4% Substantial Referral program Reporting to the Manager of Clinical Operations, the Care navigator ... the call needs to be routed to a care manager . + Completing call audits + Coordinating and managing...and cost outcomes. + Understands the organization's quality management program and the care coordinator's role within that … more
    Elderwood (09/18/25)
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  • Substance Abuse Floor Counselor

    Outreach Development Corporation (Brentwood, NY)
    …appropriate data, orienting client to his/her rights and responsibilities and program expectations. + Completes necessary administrative procedures for admission to ... Complete all needed documentation and reports in a timely manner. Informs Program leadership (Director, Asst. Director, and/or Coordinator) of any problems or… more
    Outreach Development Corporation (09/27/25)
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  • Community Connections Representative I/II (Buffalo…

    Excellus BlueCross BlueShield (Rochester, NY)
    …community-based organization meetings as required/complement or collaboration with Community Engagement Program Manager . * Gain Subject Matter Expertise (SME) ... On and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market -… more
    Excellus BlueCross BlueShield (09/02/25)
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  • Audit & Reimbursement III (US)

    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 III** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
    Elevance Health (09/27/25)
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