• Medicare MAP Advisor

    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
    Centers Plan for Healthy Living (07/15/25)
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  • Behavioral Health Medical Director…

    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
    Humana (08/09/25)
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  • Director, Operational Oversight ( Medicare

    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 (07/29/25)
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  • Senior Medical Director ( Medicare )

    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
    Molina Healthcare (06/13/25)
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  • Worklife Resource Consultant - Medicare

    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
    CVS Health (06/28/25)
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  • Medical Director - Medicare Appeals

    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
    CVS Health (08/08/25)
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  • Occupational Therapist

    Sodus Rehab & Nursing Center (Johnstown, 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 (08/08/25)
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  • Physical Therapist

    Sodus Rehab & Nursing Center (Johnstown, 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 (08/08/25)
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  • Occupational Therapist

    Tarrytown Rehabilitation & Nursing Center (Little Falls, 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
    Tarrytown Rehabilitation & Nursing Center (07/24/25)
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  • Speech-Language Pathologist

    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
    Sodus Rehab & Nursing Center (07/16/25)
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