- CVS Health (Albany, NY)
- …or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with community ... the position. **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with individuals with… more
- Mount Sinai Health System (New York, NY)
- …equivalent credential required + Proficient in CPT, HCPCS, revenue codes, and Medicare billing regulations. + Advanced proficiency in Epic, especially in EAP ... across systems + Assist in resolving problems causing payer denial or failed Medicare edits as they involve the chargemaster + Coordinate with IT and clinical… more
- New York State Civil Service (Ovid, NY)
- …eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification and Medicaid/ Medicare ... eligibility will result in the termination of employment. Additional Comments Salary Range:$93,178 - $104,230* Plus Geographic Pay - $20,000 The salary range listed in this posting reflects the full range for this graded position, factoring in annual… more
- CenterWell (Albany, NY)
- …in utilization management within Insurance industry a plus + Previous Medicare Advantage/ Medicare **Alert** Humana value's personal identity protection. Please ... be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ###@myworkday.com with instructions on how to add the information into your official application on Humana's… more
- CVS Health (Albany, NY)
- …**Position Summary** The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration groups to drive improved performance by leading ... Senior Clinical Strategist works to drive clinical performance of assigned Medicare Provider Collaboration groups by: - Establishing trusting relationships with… more
- Arnot Health (Elmira, NY)
- …receive the maximum reimbursement that is allowable. 9. Demonstrates knowledge of Medicare requirements for approved ICD-9 codes and to communicate to the provider ... when a code is not approved, and knowledge of Medicare waivers. 10. Demonstrates the ability to accurately pre-authorize / pre-certify patients exams for all… more
- CenterWell (Albany, NY)
- …and monitoring the Tele Sales Agents who are responsible for converting Medicare eligible callers to patients. The Care Delivery Call Quality Professional is ... quality auditing experience + Understanding of value-based primary care and/or Medicare Advantage + Familiarity with healthcare systems and patient satisfaction… more
- Mount Sinai Health System (New York, NY)
- …clinical studies, exposure science, studies using large administrative datasets (eg, Medicare , state health data), and ongoing longitudinal cohort studies based at ... clinical studies, exposure science, studies using large administrative datasets (eg, Medicare , state health data), and ongoing longitudinal cohort studies based at… more
- New York State Civil Service (Queens Village, NY)
- …eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain Medicaid/ Medicare eligibility will result ... in the termination of employment. Additional Comments The mission of the New York State Office of Addiction Services and Supports (OASAS) is to provide, support, and oversee a data-driven continuum of addiction services delivered with equity, dignity,… more
- New York State Civil Service (Queens Village, NY)
- …eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain Medicaid/ Medicare eligibility will result ... in the termination of employment. Additional Comments Background Investigation Requirements: Prospective appointees will be: 1) Checked against the Staff Exclusion List (SEL) maintained by the Justice Center for the Protection of People with Special Needs.… more