- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- Trinity Health (Albany, NY)
- …of our dually eligible population (patients enrolled in both Medicaid and Medicare ), as an intervention to reduce preventable hospitalizations (SO Metric) + Address ... and mitigate social care needs for colleagues, as part of the Colleague Resiliency Plan. **What will you need:** + High School Diploma required / Associates Degree preferred. + Minimum one (1) year of community involvement experience. + Ability to earn a CHW… more
- Healthfirst (NY)
- …+ Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family + Experience managing ... a Quality Assurance or Operations Audit team. + Experience working with AI or other machine learning tools to assist with streamlining QA processes. + Experience working with delegates/vendors in a healthcare insurance setting. + Demonstrated experience or… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- Molina Healthcare (Syracuse, NY)
- …HCS Department staff workload for adherence to the Policies, Procedures, Guidelines, Medicare Model of Care, and deadlines. Assures oversight and direction of ... individuals primarily responsible and assures timely completion. + Actively participates in the Department auditing program to review and communicate findings with staff and identify opportunities for improved quality and compliance. + Acts as liaison to both… more
- Catholic Health Services (Roslyn, NY)
- …insurance status to include but not limited to: ability to pay, Medicare /Medicaid status and all third party payors; Obtains pre-certification and authorizations ... required for inpatient admission or ambulatory encounters from insurance carrier or managed care company and verifies in advance coverage limits, deductible amounts, and pre-existing clauses on all procedures; Performs Daily Appointment Reconciliation to… more
- FlexStaff (Chappaqua, NY)
- …LOCALLY* The candidate MUST HAVE Medical Billing & AR Experience- Experience in Medicare Part B and in Network Managed Care, Medical Coding Modifier Experience & ... Large Volume Experience. This role is a hybrid schedule, requiring proper computer hardware including secure Wi-Fi and dual monitors to facilitate remote work. Join a reputable organization that values expertise, teamwork, and excellence. We offer a dynamic… more
- Molina Healthcare (Albany, NY)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... ability to easily access and interpret these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing (RN) license in good standing. **Preferred Education** Bachelor's Degree in Nursing **Preferred Experience**… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more