- Excellus BlueCross BlueShield (Dewitt, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the… more
- University of Rochester (Albany, NY)
- …but not limited to, The Joint Commission TJC, Center for Medicaid and Medicare Services (CMS), National Committee for Quality Assurance (NCQA), State Department ... Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910397 URMC Medical Staff Services Work Shift: UR - Day (United States of America) Range:… more
- CenterWell (Hauppauge, NY)
- …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and… more
- Ellis Medicine (Schenectady, NY)
- …discharge condition and final discharge plans. + Assists with ordering durable medical equipment. + Meets with patient, family and/or designee to ensure post-acute ... continuity of care and decrease length of stay + Appropriately refer and elevate medical and/or complex needs to appropriate case management and social work staff to… more
- City of New York (New York, NY)
- …health outcomes for all New Yorkers. CHECW sits under the Agency's Chief Medical Officer. The Bureau of Equitable Health Systems is the healthcare systems bureau ... supporting the strategic plan and vision of the Chief Medical Officer. Our mission is to apply policy, evidence,...65 or older, Blind and Disabled (ABD) Medicaid and Medicare Savings program (MSP); applying for Medicare ;… more
- Cardinal Health (Albany, NY)
- …and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- Humana (Albany, NY)
- …mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental requirements for ... experience in revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of… more
- Elderwood (North Creek, NY)
- …to advance and grow within the organization. + Competitive Perks:Full Suite of Medical , Gas allowance & Bonuses! RN Supervisor Position Overview: + The Nursing ... each unit, and other additional duties assigned by the Director of Nursing Services. RN Supervisor Shift Options: +...has earned a 4-star rating from the Centers for Medicare and Medicaid Services (CMS)-exceeding both the New York… more
- Comunilife (New York, NY)
- …supervises the Assistant Vice Presidents for Programs (AVP) for Transitional Housing, Program Director for Medical Respite, Program Director for Care ... + Directly supervise Assistant Vice President (AVPs), Program Directors for Medical Respite, Care Coordination and SCN Services; ensure effective supervision of… more