- Mount Sinai Health System (New York, NY)
- …Soarian, etc. + Knowledge of the New York State Medicaid and CMS Medicare regulations and related reporting requirements, such as STARS,QARR, MMCOR, MEDS, RAPS and ... HEDIS is a strong plus. + Experience working in a health plan or consulting actuarial, financial reporting or medical economics departments highly valuable. + Experience as a nurse informaticist highly valuable. + Experience working in healthcare provider… more
- Kaleida Health (Buffalo, NY)
- …provides reimbursement planning and is responsible for key decision-making related to Medicare , Medicaid, and other Third Party Payors to ensure payment. Provides ... facility-wide analysis of reimbursement to support the budget process.** **Education And Credentials** **Associate degree in nursing required, bachelor's preferred. RN license required upon hire.** **Experience** **3 years of Long Term Care experience… more
- Saratoga Hospital (Saratoga Springs, NY)
- …federal and accreditation requirements, including but not limited to the Centers for Medicare and Medicaid (CMS) and the Joint Commission (JC), DNV, OSHA, CMS and ... DOH. In addition, this position will support the development of a standardized organizational dyad structure with the Policy and Regulatory Readiness Manager to ensure regulatory compliance. The Clinical Regulatory Readiness Manager supports the Policy and… more
- WMCHealth (Valhalla, NY)
- …+ Researches technical guidance in UB-92 Editor, CPT/HCPCs Guide, CMS website, Medicare Manuals, etc. to resolve billing issues and promote regulatory compliance. + ... Maintains and provides information on status of audits and issues presented. + Participates in quantifying audit outcomes, including revenue realized + Researches and communicates appropriate treatment of charges to clinical managers, CDM Specialist… more
- Catholic Health Services (Melville, NY)
- …Familiarity with clinical documentation requirements. Working knowledge of Centers for Medicare and Medicaid Services rules and regulations, and interest in building ... this knowledge through experience and partnership with Care Management. Excellent communication and presentation skills (both written and oral). Teaching and coaching skills. Analytical ability and problem-solving skills. Working knowledge of electronic… more
- Heritage Ministries (Gerry, NY)
- …general accounting staff. . Knowledge of requirements and regulations set forth by Medicare and other related agencies. Benefits: Paid time off (on an accrual basis) ... Paid sick time (New York) 401k Employer contributed Medical, Dental, and vision insurance Employer paid life insurance Paid training opportunities Education Assistance plans Employee pharmacy program Special employee recognition and giveaways If you have a… more
- Molina Healthcare (NY)
- …MTM Pharmacy Services staff work to ensure that Molina members have access to Medicare Star medications and those meds are used in a cost-effective, safe manner. ... These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing… more
- Molina Healthcare (Yonkers, NY)
- …have strong experience in Jira and smartsheets is preferred + Knowledge in Medicare , Medicaid and Marketplace is highly preferred. + Able to develop detailed project ... plans, communication plans, schedules, role definition, risk management and assumptions. + Complete mastery of standard applications and project specific software. Able to learn new software with little to no instruction within a short timeframe and instruct… more
- Arnot Health (Elmira, NY)
- …interpretation of regulatory standards, including The Joint Commission and Centers for Medicare and Medicaid Services (CMS); ensures a constant state of readiness; ... advises on policy development, educates health care providers on the relevance of standards supporting a culture of safe, high-quality patient care, and contributes leadership and assistance to enterprise-wide initiatives. Performance Improvement and… more
- The New Jewish Home (Bronx, NY)
- …the application of continuous improvement principles and best practices among Medicare and Medicaid products, in collaboration with senior leadership and service ... delivery management. 11. Designs and evaluates clinical support and education programs that are integrated with and facilitate quality improvement strategies and achievement of the Enterprise's strategic objectives. 12. Develops strategic plans and policies… more