• Case Management Assistant

    WMCHealth (Valhalla, NY)
    …with the case manager and care coordinator, implement the discharge review program mandated by New York State Department of Health to facilitate issuance of ... preferred + Knowledge of regulatory agency standards; Centers for Medicare & Medicaid Services, and Det Norske Veritas (DNV) standards, preferred About Us: WMC… more
    WMCHealth (08/02/25)
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  • Registered Nurse (RN) - Utilization Management

    Rochester Regional Health (Rochester, NY)
    …potential inpatient medical necessity denials. Review patient class in the event manager , assist with LOC determination retrospectively, and changes patient class as ... + BS degree + Knowledge of Federal and State regulations (DOH, Medicaid /Medicare) + Knowledge of third party payer and/or managed care payment principles… more
    Rochester Regional Health (08/02/25)
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  • Transition of Care Nurse LPN

    Premier Medical Group of the Hudson Valley (Poughkeepsie, NY)
    …(Hourly) LOCATION: 696 Dutchess Turnpike, Poughkeepsie, NY 12603 REPORTS TO: Manager , Care Coordination SHIFT/CORE HOURS: Monday-Friday 8:30 AM-5:00 PM POSITION ... functions to complete the process. EDUCATION & EXPERIENCE + Minimum education: accredited nursing program (LPN or RN) with an active NYS license. + At least 1 year… more
    Premier Medical Group of the Hudson Valley (07/31/25)
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  • Occupational Therapist

    Tarrytown Rehabilitation & Nursing Center (Little Falls, NY)
    …Provides Occupational Therapy plan of treatments and modalities + Modifies treatment program level, intensity and techniques based on the resident's response to ... in internal audits as directed + Possess a strong knowledge of Medicare, Medicaid and other payment sources and their responsibility in the SNF setting +… more
    Tarrytown Rehabilitation & Nursing Center (07/24/25)
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  • Healthcare Risk Management - St Peters Health…

    Trinity Health (Albany, NY)
    …visitors, vendors, various regulatory and professional agencies. **SUPERVISED BY:** Manager of Risk Management **SUPERVISES:** none **CAREER PATH:** Management ... Supports the education components of the facility's risk management program . Promotes the organizational patient safety initiatives. **LOSS PREVENTION/PATIENT… more
    Trinity Health (07/22/25)
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  • Director, Appeals & Grievances (Medicare…

    Molina Healthcare (Rochester, NY)
    …standards and requirements established by the Centers for Medicare and Medicaid . **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of the ... performance indicators (KPI's) with multiple targets depending on Medicare Program and State requirements. **Job Qualifications** **Required Education** Associate's… more
    Molina Healthcare (07/18/25)
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  • Director, System Payer Contracting (On-site)

    Albany Medical Center (Albany, NY)
    …stays on top of national and local payer trends. + Planning and Program Development and Oversight + Identifies, facilitates, and builds systems and standardized ... value-based enterprise financial acumen + Demonstrated leader of people and manager of resources. + Demonstrated success in orchestrating, leading, and overseeing… more
    Albany Medical Center (07/16/25)
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  • Licensed Benefits Advisor (Bilingual Preferred…

    Centers Plan for Healthy Living (New York, NY)
    …selling/marketing and performing all required tasks assigned by the Sales Manager . Incumbent will be responsible for educating and enrolling potential beneficiaries ... by explaining program benefits in a manner that is compliant with...manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and regulations. The… more
    Centers Plan for Healthy Living (07/15/25)
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  • Community Health Worker Per Diem

    Trinity Health (Syracuse, NY)
    …support services. Examples include health coverage via the insurance marketplace, Medicaid , Medicare, social security benefits, food, and housing services. Serves as ... allocation accurately (if applicable). Other duties as needed and assigned by the manager . Maintains a working knowledge of applicable Federal, State, and local laws… more
    Trinity Health (07/15/25)
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  • Mgr, Social Work Services

    Rochester Regional Health (Rochester, NY)
    Job Title: Manager , Social Work ServicesDepartment: Social Work Location: Rochester General Hospital Hours Per Week: 40Schedule: Monday-Friday, 8am-4:30pm SUMMARY: ... manage Social Work Services and supervise the Social Work staff, including Medicaid Specialists, office support, and interpreters. Responsible for the quality of the… more
    Rochester Regional Health (07/04/25)
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