- Blue Matter (New York, NY)
- …planning also spans diverse care settings with distinct market access dynamics. As a Manager with Blue Matter, you will join a startup firm with a dynamic and ... pharmacy benefit across all major US payer segments (eg, Commercial, Medicare , Medicaid, and Federal Markets) + Demonstrated knowledge of reimbursement methodologies… more
- Centers Plan for Healthy Living (Queens, NY)
- …need for healthy living. JOB SUMMARY : The Licensed Benefits Advisor- Medicare Sales, Maintains relationships, services our existing customers and secures new ... and performing all required tasks assigned by the Sales Manager . Incumbent will be responsible for educating and enrolling...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- Elevance Health (East Syracuse, NY)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... federal health programs. The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for … more
- CVS Health (Albany, NY)
- …with provider engagement, relations, or account management. + Working knowledge of Medicare contracts. + An understanding of value based contracts, how they work, ... what is the value. + Strong presentation skills, the ability to communicate effectively. + Mastery of problem solving and decision making skills + Strong MS Office skills. Preferred Qualifications: + The ability to use data to tell a story. + Mastery of growth… more
- Calvary Hospital (Bronx, NY)
- …+ Coordinate assessment and documentation requirements for continued Medicare /Medicaid Recertification's. + Prepare statistical reports for Corporate Compliance ... Regulations @ Home and QA & I. + Maintain overall supervision of discharge medical record completion prior to final filing. + Performs other related duties as assigned. Requirements Qualifications: + Current NYS RN License + Current Driver's License. +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …managed care benefit plans and strong knowledge of government program contracts ( Medicare and Medicaid) and benefits, preferred. + Strong written and verbal ... communication skills + Ability to multitask and balance priorities. + Must demonstrate ability to work independently on a daily basis. + Deliver efficient, effective, and seamless care to members. Level II (in addition to Level I Qualifications) + Minimum of 2… more
- CVS Health (Albany, NY)
- …of 3 years managing/leading a team. + Experience working in Medicare , Medicaid, or Commercial Health Insurance. **Preferred Qualifications** + Experience working ... in credentialing operations. + Strong written and verbal communication. **Education** + Bachelor's degree preferred or a combination of professional work experience and education. **Pay Range** The typical pay range for this role is: $67,900.00 - $199,144.00… more
- Healthfirst (NY)
- …+ Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family + Experience managing ... a Quality Assurance or Operations Audit team. + Experience working with AI or other machine learning tools to assist with streamlining QA processes. + Experience working with delegates/vendors in a healthcare insurance setting. + Demonstrated experience or… more
- Northwell Health (Staten Island, NY)
- …companies and physicians regarding utilization issues. + Utilizes important message from Medicare (IMM) when appropriate. + Ensures managed care reviews are up to ... date and accurately reflect patient's clinical progress and acute needs. + * Participates in the quality management of patient care outcomes. + Submits data to management regarding case management and/or quality initiatives. + Participates in data collection… more
- Arnot Health (Bath, NY)
- …the Long Term Care staff, attends weekly care conference meetings, and weekly Medicare A review with care team and therapies. + Demonstrates effective time ... management, flexibility and priority setting. + Promotes and ensures the delivery of quality resident care through competency based assignments and supervision of staff. + Supports the philosophy and objectives of the Long Term Care Department. + Ensures the… more