- BAYADA Home Health Care (Delhi, NY)
- **At Home Care, Inc. is a Medicare certified home health agency with a 4 STAR Rating for quality and patient satisfaction!** **At Home Care, Inc.** is looking for ... document doctors' orders. + Perform client assessments, as necessary. + Case management and coordination. + Accurately document observations, interventions, and… more
- New York State Civil Service (Schenectady, NY)
- …of CPR compressions on the floor would ensure nurse ability to perform in worst case scenario, since we use no backboards in OPWDD. Other Duties as assigned by ... individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program).… more
- New York State Civil Service (West Brentwood, NY)
- …eligibility for full and unconditional participation in the Medicaid and Medicare programs which must be maintained for continued employment. Failure to ... employment application may bar appointment or result in removal after appointment. Each case will be determined on its own merits, consistent with the applicable… more
- Humana (Albany, NY)
- …+ Identify important clinical and experience problems and build the business case to solve them through application of clinical, analytical, and business expertise. ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Highmark Health (Albany, NY)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... Is responsible for or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs in the facilities to identify… more
- CDPHP (Albany, NY)
- …and responses to audits and RFPs. The Coordinator negotiates single case agreements for authorized medical services with non-participating providers. Network ... as assigned Qualifications: + 3 years managed care experience with commercial, Medicare and Medicaid lines of business and regulatory requirements + Associates… more
- CVS Health (Albany, NY)
- …best course of action to take in a timely and effective manner. Conducts case reviews and provides feedback to investigators on completeness and quality of the ... in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and written communication… more
- Arnot Health (Bath, NY)
- …the Long Term Care staff, attends weekly care conference meetings, and weekly Medicare A review with care team and therapies. + Demonstrates effective time ... as appropriate/required. + Assists clinical staff with documentation for MDS based Case Mix to ensure appropriate classification of residents for reimbursement. +… more
- Molina Healthcare (Albany, NY)
- …contact information is current and up to date. + Effectively communicate general Medicare and Medicaid plan benefits to existing members. + Interact with appropriate ... with completion of comprehensive medication reviews through pre-work up to case preparation. + Proactively identify ways to improve member relations. **Job… more
- Staffing Solutions Organization (Albany, NY)
- …conduct quality assurance reviews and assist in developing procedures for specific case scenarios, + Create and maintain specific spreadsheets used for tracking ... Professional experience in public health insurance programs, including New York's Medicaid, Medicare and/or Child Health Plus and supervisory experience is a plus.… more