- Centene Corporation (Queens, NY)
- …is critical in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special ... + Oversee Medicare -specific VBP contracts, focusing on implementation, performance management, and education of provider partners regarding CMS-aligned… more
- Humana (Albany, NY)
- …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will ... rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid products, or other Medical… more
- Molina Healthcare (New York, NY)
- …member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, ... Provider Services. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of… more
- Molina Healthcare (NY)
- …member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, ... a managed care setting. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines… more
- Centers Plan for Healthy Living (Queens, NY)
- …working weekends and requires frequent travel to various Centers Plans or Healthy Living Advantage Care Medicare HMO Plan sites located throughout the five (5) ... boroughs. Territory Management + Maintain Centers Plans for Healthy Living Advantage Care Medicare HMO Plan visibility in the community by monitoring multiple… more
- Humana (Albany, NY)
- …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements and will ... Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in...experience in a medical management review organization such as Medicare Advantage , managed Medicaid, or Commercial health… more
- Humana (Albany, NY)
- …Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and Medicare Advantage value based programs. DVACO is a joint venture among ... grouping, with more than 2,000 physicians and approximately 70,000 Medicare fee-for-service beneficiaries. Additionally, DVACO currently holds performance -based… more
- Humana (Albany, NY)
- …growth strategy, leading the development of the annual Medicare Advantage strategic plan, monitoring segment-wide operational performance , and refreshing the ... Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement… more
- New York State Civil Service (Queens Village, NY)
- …be terminated from your employment.If appointed, you may be required to become an enrolled Medicare provider ; obtain and provide to your employer a National ... approve leave and track time and attendance; and complete performance evaluations. * Functions as a member of an...Comprehensive Adult Transitional Home if required, when the assigned provider is not available.* Provide medical expertise… more
- Humana (Albany, NY)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
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