- Humana (Albany, NY)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will...NCD/LCD, MCG(R) or InterQual** **The Medical Director conducts clinical case reviews of requests received by members of the… more
- New York State Civil Service (Queens Village, NY)
- …Zip Code 11427 Duties Description The Addiction Counselor 2 will supervise a case management team providing addiction services and supports in addition to performing ... and group counseling is provided to all clients assigned to subordinate case management team.* Completing required client and facility documentation (both electronic… more
- Molina Healthcare (NY)
- …and the site of service. This position will be supporting our Washington State Medicare plan. We are seeking a candidate with previous Case Management experience ... of MS Suite, organized and analytical thinking. Experience with Medicare /Medicaid, MS 365 and familiarity with claims is highly...365 and familiarity with claims is highly preferred. The Case Manager must be able to work in a… more
- New York State Civil Service (East Syracuse, NY)
- …omitted information may bar appointment or result in removal after appointment. Each case will be determined on its own merits, consistent with the applicable ... are responsible for payment of all required fees.Medicaid and Medicare : In order to be eligible for appointment and...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- Humana (Albany, NY)
- …includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board ... experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute… more
- Molina Healthcare (Yonkers, NY)
- …for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare , and Marketplace lines of business. This includes direct management of ... role requires experience across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general… more
- New York State Civil Service (Poughkeepsie, NY)
- …Psychology, etc. The Medical Specialist 2 will also participate in clinic case reviews and clarifying information in patients' medical histories; providing approvals ... on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal...appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a… more
- New York State Civil Service (Albany, NY)
- …clinical group curriculum to meet Joint Commission and Center for Medicare and Medicaid Services programming requirements.* Completing required paperwork including ... intake, core history, treatment plans, and progress notes. * Providing case management services.* Coordinating and facilitating discharge planning with Social Work… more
- University of Rochester (Rochester, NY)
- …to authorizations, coordination of benefits, baby not on policy, Cobra entitlement, Medicare Lifetime Reserve days, and Medicare Advantage issues. This role ... families, third-party payers, governmental agencies, employers, social work, financial case management, clinical team and contracting. The Health Insurance &… more
- New York State Civil Service (Bronx, NY)
- …management, crisis stabilization, and therapeutic planning.* Participating in case conferences, didactics, and clinical supervision. Minimum Qualifications ... on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal...upon current licensure to practice medicine and in the case of Psychiatrist 2 (C&Y), current certification in child… more