- Humana (Albany, NY)
- …experience in a medical management review organization, such as Medicare Advantage , managed Medicaid, or Commercial health insurance . + Experience with ... internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand… more
- WMCHealth (Warwick, NY)
- …+ Obtain Pre-Admission Authorizations and continued stay authorizations with Medicare , Medicare Advantage , Medicaid, and Insurance Programs. + Maintain ... other providers, regulatory agencies, billing agencies, and auditing agencies including Medicare , Medicaid, and third-party billers. + Scans, uploads, and files… more
- Centene Corporation (Queens, NY)
- …in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). ... Act as a strategic advisor on contract structure and payment methodologies for Medicare Advantage and D-SNP providers, supporting new contract negotiations and… more
- TEKsystems (Rochester, NY)
- …the job - Responsible for maintaining accurate and up-to-date knowledge of all Medicare Advantage regulations and possess the ability to communicate to members ... desirable Skills Customer service Help desk Support Customer support Medicare Medicare insurance Additional Skills...We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are… more
- Centene Corporation (Bronx, NY)
- …+ Identify prospective enrollees and determine eligibility for participation in the Advantage Medicare product + Understand and apply all policies and ... procedures pertaining to: + Disclosures and provisions of the Advantage Medicare product + Enrollment and disenrollment + Develop a presence in the local… more
- Kelly Services (Greece, NY)
- …line with established policies and procedures. + Maintaining current knowledge of Medicare Advantage regulations and corporate policies. + Skillfully resolving ... yes, please see this opportunity!** **Kelly(R) is seeking a Medicare Customer Satisfaction Advocate to work at a top... Customer Satisfaction Advocate to work at a top insurance client in the Greece/ Rochester, NY area. Let… more
- Elevance Health (New Hyde Park, NY)
- …for completing diverse and complex projects related to risk adjustment analytics in the Medicare Advantage line of business. **How You Will Make an Impact** ... + Analyzes and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives. + Performs data mining and data-driven… more
- Humana (Albany, NY)
- …experience in a medical management review organization, such as Medicare Advantage , managed Medicaid, or Commercial health insurance . + Experience with ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand… more
- Humana (Albany, NY)
- …experience in a medical management review organization, such as Medicare Advantage , managed Medicaid, or Commercial health insurance . + Experience with ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand… more
- Humana (Albany, NY)
- …experience in a medical management review organization, such as Medicare Advantage , managed Medicaid, or Commercial health insurance . + Experience with ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more