- 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 ... to support efficient and compliant subrogation operations across Medicaid, Medicare , and Marketplace populations. + Collaborate with legal, claims, provider… more
- WMCHealth (Warwick, NY)
- …leadership and clinical assistance to all facility personnel to ensure facility compliance with Nursing Care Standards as applied to Resource Utilization Groups. The ... and appropriateness of placement + Assesses resident's potential eligibility for Medicare coverage. Initiates Medicare Certification and recertification for… more
- Molina Healthcare (Syracuse, NY)
- …oversight of processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has ... decision-making accountability for ensuring compliance with complex regulatory requirements, protecting the integrity of enterprise revenue, and enabling the… more
- Humana (Albany, NY)
- …time with demonstrated advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The nature of the work ... concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility… more
- Trinity Health (Schenectady, NY)
- …(QRP) processes for the inpatient rehabilitation units. **Responsibilities:** + Assures compliance with all State and Federal requirements related to and oversees ... capture of documented conditions. + Tracks and reports regularly on 60% rule compliance . + Collaborates with interdisciplinary members of the team. + Assists with… more
- Humana (Albany, NY)
- …have comprehensive knowledge of processes, policies and procedures as well as compliance guidelines. Will support achieving operational and compliance key ... regulations or adjacent sectors **Preferred Qualifications** + Comprehensive knowledge of Medicare , Medicaid, and DSNP encounter processes and policies. + Working… more
- Molina Healthcare (Albany, NY)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... and solutions that drive measurable improvement. + Partner with finance and compliance to develop business cases and support reporting that ties operational outcomes… more
- GMHC (New York, NY)
- …includes support within a range of health benefit options such as ADAP, Medicaid, Medicare , COBRA, and Marketplace plans, all with a focus on meeting people where ... TREAT. + Participate in internal program reviews, data quality checks, and ensure compliance with funder reporting standards. + Assist in the collection of client… more
- CenterWell (Albany, NY)
- …delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- Centene Corporation (East Syracuse, NY)
- …and Salesforce are strongly encouraged to apply.** **Position Purpose:** Manages either the Medicare Sales or the Broker Field Sales teams to drive and achieve ... strategy impacting the recruitment, onboarding, training, engagement, production, and compliance adherence of assigned independent agent base. + Develops… more