- CVS Health (Albany, NY)
- …Examples include ensuring data standards are synchronized across Medicaid and Medicare platforms, ensuring duals workflows are support across systems, ensuring duals ... and Key Performance Indicators are met, mange ad-hoc requests, and ensure compliance with regulatory requirements. + Demonstrate an ability to lead through influence… more
- Humana (Albany, NY)
- …are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. **Equal ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Highmark Health (Albany, NY)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- New York State Civil Service (West Brentwood, NY)
- …assessments as part of treatment plan development * Monitors patient compliance with treatment goals.* Completes required client and facility documentation (both ... eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification and Medicaid/ Medicare … more
- Evolent (Albany, NY)
- …+ Participates in on-going training programs to ensure quality performance in compliance with applicable standards and regulations, as well as, being audited to ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of disciplinary or legal action… more
- Humana (Albany, NY)
- …data driven methods to develop and influence formulary strategies for Humana's Medicare line of business. + Utilizes broad understanding of pharmacy, managed care, ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- City of New York (New York, NY)
- …Engagement Unit, Health and Hospitals, and Community-based Organizations. To ensure full compliance of these partnerships the Bureau of Equitable Health Systems is ... 65 or older, Blind and Disabled (ABD) Medicaid and Medicare Savings program (MSP); applying for Medicare ;...and Medicare Savings program (MSP); applying for Medicare ; and other government sponsored programs such as the… more
- Highmark Health (Buffalo, NY)
- …outcomes as a result of workflow transformation, superior coding accuracy, and Medicare STARS gap closure to providers based upon each individual gain/risk share ... for superior coding accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk revenue opportunities. + Function as the… more
- New York State Civil Service (West Brentwood, NY)
- …assessments as part of treatment plan development * Monitors patient compliance with treatment goals.* Completes required patients and facility documentation (both ... eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain Medicaid/ Medicare eligibility will result… more
- Molina Healthcare (Yonkers, NY)
- …Business Administration, Healthcare or related field. **Preferred Experience** * 2+ years compliance related experience. * 1+ years in Medicare . **Preferred ... administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care… more