- Molina Healthcare (Rochester, NY)
- **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… more
- SUNY Upstate Medical University (Syracuse, NY)
- …resources. Ensure accurate coding and documentation to support quality initiatives and Medicare compliance . Work closely with clinical teams across seven Primary ... Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care clinics. This role… more
- CVS Health (Albany, NY)
- …sales divisions of Medicare Advantage organizations, as well as operations, enrollment, compliance and finance + Mastery of Medicare Sales and Marketing ... with heart, each and every day. **Job Description** + The Sr. Manager, Medicare Sales Strategy develops and executes strategic initiatives to drive sales growth… more
- City of New York (New York, NY)
- …a variety of topics, including legal ethics, conflicts, privileges, federal grants, Medicare compliance , and outside employment. Division attorneys also conduct ... position of Assistant Corporation Counsel in the Ethics & Compliance Division. Attorneys with more than five years of...Senior Counsel position in the division. The Ethics & Compliance Division has counseling and ligation adjacent roles and… more
- Molina Healthcare (Albany, NY)
- …or related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with ... **Job** ** ** **Summary** Safeguard member trust and plan compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM… more
- Molina Healthcare (Buffalo, NY)
- …as needed + Primary point of contact for the internal partners, ie Medicare Administration, Compliance and Health Plan Operations. Coordinates and facilitates ... including goal setting and score card development + Monitors and enforces compliance with enterprise-wide processes and develops workflows for all staff to follow… more
- Northwell Health (Garden City, NY)
- …coding rules and regulations to the validation review process. 6.Reviews codes on Medicare /non- Medicare charts for compliance to rules and conventions. ... and principals; performs coding audits for optimization. 4.Audits and reviews Medicare /non- Medicare charts to ensure that proper standards are maintained… more
- Northwell Health (Westbury, NY)
- …coding rules and regulations to the validation review process. + Reviews codes on Medicare /non- Medicare charts for compliance to rules and conventions. + ... the Medical Record. Job Responsibility + Audits and reviews Medicare /non- Medicare charts to ensure that proper standards...changes necessary to provide the most valid documentation in compliance with Federal and State regulations. + Reports to… more
- Sedgwick (Albany, NY)
- …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
- 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, ... explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and regulations. The Medicare… more