- City of New York (New York, NY)
- …of Quality Assurance (OQA), Office of Accountability Strategies (OAS), Compliance and Contract Monitoring (CCM), Investigation, Revenue and Enforcement ... spending. This work includes identifying Medicaid clients who should apply for Medicare , identifying Medicaid clients who should be part of buy-in program, and… more
- Evolent (Albany, NY)
- …landscape + Good knowledge US Healthcare - Payer side, Knowledge of Medicare , Medicaid, Commercial Plans and understanding on claims workflow, members, providers + ... may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final… more
- HCR Home Care (Rochester, NY)
- …, and participate in , the Agency's mandat ory HIPA A/Privacy Program and Employee Compliance Program . + Read and adhere to all Agency policies and procedures and ... to problem - solve effectively. + Possess es knowledge of the Medicare /Medicaid guidelines governing home health agencies. + Organized, detail-oriented , and… more
- Centene Corporation (Queens, NY)
- …and procedures. + Oversee the Provider Relations department to ensure in compliance with company policies and standards, government laws, regulations and contracting ... experience in a managed care or insurance environment, preferably in Medicare or Medicaid. Previous management experience including responsibilities for hiring,… more
- Guthrie (Vestal, NY)
- …Home Health NY. 2. Oversees all functions of the Agency to ensure compliance with all required regulations. Maintains a high level of professional competence by ... care services. 8. Assumes responsibility for the day to day functioning of Medicare certified home health agency. 9. Must have excellent verbal and nonverbal… more
- Stony Brook University (Stony Brook, NY)
- …the Hospital Charge Description Master to optimize revenue generation and maintain compliance with State, Federal and third party payer regulations and requirements ... + Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare and New York Medicaid reimbursement methodologies. + Knowledge of other… more
- Elderwood (North Creek, NY)
- …Elderwood at North Creek has earned a 4-star rating from the Centers for Medicare and Medicaid Services (CMS)-exceeding both the New York state average (3.33) and ... of residents to ensure that the highest degree of quality care and regulatory compliance is maintained at all times. + New York State LPN license required. Active… more
- Finger Lakes Health (Waterloo, NY)
- …Nursing-LTC, coordinates all Medicare assessments, care planning and reimbursement activities for the facility to assure compliance with regulatory agencies. na ... #1075 Waterloo, NY, USA Pay Range $38.01 - $42.00 Job Description Under the direction of the Director of… more
- Elderwood (North Creek, NY)
- …Elderwood at North Creek has earned a 4-star rating from the Centers for Medicare and Medicaid Services (CMS)-exceeding both the New York state average (3.33) and ... residents to ensure that the highest degree of quality care and regulatory compliance is maintained at all times. Responsibilities (RN - Registered Nurse): + Direct… more
- CenterWell (Albany, NY)
- …+ Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years clinical experience ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more