- Humana (Albany, NY)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The Corporate Medical ... Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- Highmark Health (Albany, NY)
- …experience in managed care pharmacy + 2 years of clinical account management experience in Medicare as part of the 4 year managed care experience + 2 years of ... experience analyzing pharmaceutical cost of care data **Substitutions** + None **Preferred** + Masters of Pharmacy or Masters of Business Administration + AMCP-ASHP accredited residency in managed care pharmacy + Experience leading or participating in Pharmacy… more
- Centers Plan for Healthy Living (Staten Island, NY)
- … Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing Physical Requirements: The physical requirements described ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and... MAP Advisor- Will promote and sale MAP and Medicare Line of Business, maintains relationships, services our existing… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests for services. The ... Medical Director work assignments involve moderately complex to complex issues...and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will… more
- Centers Plan for Healthy Living (Staten Island, NY)
- … Medicare or Sales experience SCOPE INFORMATION # Direct Reports: Director of Medicare Marketing PHYSICAL REQUIREMENTS: The physical requirements described ... healthy living. JOB SUMMARY : The Licensed Benefits Advisor- Medicare Sales, Maintains relationships, services our existing customers and...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care clinics. This role ... supervision of a licensed provider. The RN/CNS will report to the UUMAS Director of Quality and Practice Operations and collaborate closely with Primary Care clinic… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for ... current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. + Carries out job… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health, SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director ...dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health, SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director ...dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more