- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... strategy **Preferred Qualifications** + Experience in senior healthcare and/or Medicaid + Formal qualitative (1:1 interviews, focus groups) moderation experience… more
- St. John's Embrace Living (Rochester, NY)
- …in lower levels of care, if appropriate + Works with health insurances, Medicare , Medicaid and families to facilitate coverage and payment + Consistently ... often with interruptions, as well as familiarity with health insurances and Medicaid Core Organizational Competencies: + St. John's Brand Characteristics - Embrace… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... investigations of reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud and Waste Professional 2 coordinates investigation… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... of Network Adequacy requirements and process optimization, primarily focusing on the Medicaid line of business, with a deep understanding of network build… more
- Access: Supports For Living (Middletown, NY)
- …working knowledge of behavioral health billing in New York State, particularly regarding Medicare , Medicaid , Medicaid Managed Care, and Commercial Insurance. ... Key Responsibilities + Lead and supervise a billing team of up to 8 staff. + Manage all aspects of the revenue cycle, including billing systems, insurance verifications/authorizations, collections, and payment processes. + Maintain a clear understanding of… more
- 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 ... Home Health Aide Program (CHHA) and Managed Long-Term Care (MLTC), Medicaid , insurance verification, Maximus procedures, and MLTC enrollment. . Collaborate and… more
- Preferred Home Care of New York (Brooklyn, NY)
- …Office who understands the regulations governing the home care field, related to Medicare , Medicaid and other insurance, and is committed to excellence in ... on services we provide + Send referral to MLTC for potential enrollment or Medicaid assistance + Send referral to appropriate CHHA for skilled services + Determine… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... Intelligence Engineer position will be supporting BI work for our Medicare organizations. **Senior Business Intelligence Engineer** : + Develops and maintains… more
- Humana (Albany, NY)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... reporting on progress, challenges, and achievements to management. + Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs… more
- Cognizant (Albany, NY)
- …Director based on the review of clinical documentation in accordance with Medicare , Medicaid , and third-party guidelines. . Effectively document and log ... Reviews can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review retro-authorizations in… more