- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and...external processes are followed + Update customer file in Case Tracker with summary of interaction + Interact with… more
- Humana (Albany, NY)
- …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... includes some experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing Board Certification in an… more
- Sedgwick (Albany, NY)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance RN Medicare Compliance Sr **PRIMARY PURPOSE OF THE ROLE:** To perform provider outreach, ... review, and analysis and interpretation of interventions for the preparation of Medicare Set-Aside allocations. **ARE YOU AN IDEAL CANDIDATE?** We are looking for… more
- Molina Healthcare (Albany, NY)
- …and due-date logic * Proven history of building-or running-real-time dashboards that keep case aging within SLA * Demonstrated skill in root-cause triage that routes ... Quality, and Operations to fund high-return enhancements. **Core** ** ** **Duties** 1. Case Audits - Run scheduled and ad-hoc audits across internal and delegated… more
- Molina Healthcare (Yonkers, NY)
- …the performance of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that ... License without restrictions (free of sanctions from Medicaid or Medicare ) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare… more
- CVS Health (Albany, NY)
- …various life and work situations. + Appropriately documents member interactions and research/ case fulfillment in the system. + Works in an inbound and outbound ... + 1+ year(s) experience in social work, social services, or case management field. + Private, confidential workspace free from distractions.professional,… more
- Molina Healthcare (NY)
- …to AVP, VP and senior management + Consultative role, develops business case methodologies for programs, develops and coordinates implementation of business strategy ... + Collaborates and facilitates activities with other units at corporate and Molina Plans. **JOB QUALIFICATIONS** **Required Education** Bachelor's degree or equivalent combination of education and experience **Required Experience** 7-9 years **Preferred… more
- CVS Health (Albany, NY)
- …Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a business ... and clinical liaison to network providers and facilities if needed, to support the effective execution of medical services programs by the clinical teams. **Required Qualifications** *Two (2) or more years of experience in Health Care Delivery System eg,… more
- Tarrytown Rehabilitation & Nursing Center (Cortlandt, NY)
- …resident, staff and family education and in-servicing + Demonstrates working knowledge of Medicare Part A PPS case management + Complies with Federal and ... Participates in internal audits as directed + Possess a strong knowledge of Medicare , Medicaid and other payment sources and their responsibility in the SNF setting… more
- Sodus Rehab & Nursing Center (Massena, NY)
- …progress notes and re-certifications per facility policy. + Demonstrates working knowledge of Medicare Part A PPS case management + Complies with Federal and ... accordance with established acceptable time frames + Possess a strong knowledge of Medicare , Medicaid and other payment sources and their responsibility in the SNF… more
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