- RiseBoro Homecare Inc. (Brooklyn, NY)
- …base. This role requires a strong understanding of homecare regulations related to Medicare , Medicaid, and other insurance programs. The Intake Specialist will ... Health Aide Program (CHHA) and Managed Long-Term Care (MLTC), Medicaid, insurance verification, Maximus procedures, and MLTC enrollment. . Collaborate and… more
- Claxton-Hepburn Medical Center (Ogdensburg, NY)
- …management, best practice and current treatment regimens. + Ability to interpret Medicare , Medicaid and commercial insurance plans and benefits. + Ability ... to multitask, problem solve complex situations, work around interruptions, and cope with stressful situations. + Basic computer knowledge. + Maintaining confidentiality of all patient information. + Maintaining quality assurance and compliance with all… more
- WMCHealth (Suffern, NY)
- …in the State of New York as a Registered Nurse. Understanding of Medicare /Medicaid criteria and insurance regulations and reimbursement. EDUCATION: A Bachelor's ... of Science in Nursing, preferred OTHER: If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal… more
- Philips (Manhattan, NY)
- …and presenting clinical evidence to physicians. + Being an expert on Medicare , Medicaid and private insurance coverage-criteria for InCourage vest therapy, ... while effectively educating healthcare teams in identifying patients who meet coverage criteria. Obtaining medical record documentation in order for coverage to be obtained. + Analyzing data to effectively target priority healthcare teams and create sales call… more
- Healthfirst (Brooklyn, NY)
- …planning, case management, and//or medical surgical nursing** **Knowledge of health insurance , Medicaid, Medicare and MLTCP** **Experience working with a ... frail adult or elderly population with the ability to determine appropriate care plans and services for frail population as well as negotiate initial service plans so that members and families are in agreement** **Language preferences - Spanish, Russian,… more
- Healthfirst (NY)
- …skills** **Adept at planning, organizing, and executing** **Knowledge of health insurance , Medicaid, Medicare and MLTCP** **Care management experience in ... a clinical managed care environment and knowledge of best practices** **Knowledge of UM//QM case philosophies and reporting requirements to state and federal agencies** **Ability to allocate, monitor, and control resources while delegating and monitoring… more
- Humana (Albany, NY)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance . + ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- CenterWell (Albany, NY)
- …Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **About us**… more
- SUNY Upstate Medical University (Syracuse, NY)
- …with practice). Must have Master's Degree, NPI number, DEA certification, medical malpractice insurance and be Medicare enrolled with Medicare Identification ... Message to Applicants: Our benefits package includes health, dental and vision insurance , eligibility for employer 401k funding after 1 year (3% quarterly/5% annual… more
- SUNY Upstate Medical University (Syracuse, NY)
- …with practice). Must have Master's Degree, NPI number, DEA certification, medical malpractice insurance and be Medicare enrolled with Medicare Identification ... encouraged to apply. Our benefits package includes health, dental and vision insurance , eligibility for employer 401k funding after 1 year (3% quarterly/5% annual… more