- Molina Healthcare (Yonkers, NY)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
- Molina Healthcare (Albany, NY)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more
- WMCHealth (Valhalla, NY)
- …The technician ensures that all activities are performed in compliance with regulatory guidelines, policies, and procedures. Responsibilities: + Operational ... Support: + Accurately prepare new and refill prescriptions, ensuring compliance with Specialty Pharmacy policies and regulatory guidelines + Transcribe incoming… more
- Humana (Albany, NY)
- …submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the ... encounter acceptance rate by Medicaid/ Medicare . Looks for long term improvements of encounter submission...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Bassett Healthcare (Cooperstown, NY)
- …your name, "How may I help you?") as observed by Supervisor and as noted in compliance reports Ends calls by asking patient if there is anything else we can do for ... them today as observed by Supervisor and as noted in compliance reports Takes clear, complete and accurate phone messages,(and follows up on these messages to make… more
- Humana (Albany, NY)
- …best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various multi-disciplinary ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager sits in...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Healthfirst (NY)
- …+ Performs first level review of all marketing materials to ensure compliance with State and Federal guidelines. + Prepares and submits marketing materials ... Provides support to all internal stakeholders during the annual Medicare Go to Market project in preparation for the... Go to Market project in preparation for the Medicare Annual Enrollment Period (AEP). + Contributes to the… more
- SUNY Upstate Medical University (Syracuse, NY)
- …+ Initiate appropriate diagnostic, therapeutic, medical and nursing actions in compliance with approved protocols in conjunction with the physician of record. ... must be consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or PTAN) OR be eligible for Medicare … more
- Elderwood (Hornell, NY)
- …Act requirements, facility philosophy, and operational policies while maintaining compliance with other government agency laws and regulations. + Communicates ... + Supervise all admissions and readmissions for eligibility or denial of Medicare Skilled services regulations. + Notify all providers, in writing, within 24… more
- Intermountain Health (Albany, NY)
- …of value-based care by Intermountain Healthcare to appropriate populations. It ensures compliance and accurate submission of publicly reported data for all payers. ... with ICD-10-CM and Official Coding Guidelines as determined by Centers for Medicare and Medicaid Services (CMS), National Center for Health Statistics (NCHS), US… more