- 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. ... a part of our caring community and help us put health first** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app hydrated via… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …by explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and regulations. The ... Responsibilities: + Educate prospects on CPHL MAP product designed for Full Medicaid and Medicare recipients that need in home care and Long-term care services,… more
- Molina Healthcare (Syracuse, NY)
- …documents. + Lead regularly scheduled business meetings. + Interpret and analyze Medicare and Medicaid communications. + Review and interpret internal dashboards ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and ... benefit plans and strong knowledge of government program contracts ( Medicare and Medicaid ) and benefits, preferred. + Strong written and verbal communication… more
- MVP Health Care (Rochester, NY)
- …integrated, person-centered care. + Compliance & Quality: Ensure adherence to Medicaid , Medicare , and accreditation standards (eg, NCQA), including documentation ... To achieve this, we're looking for a **Case Manager, Medicaid Long Term Support Program** to join #TeamMVP. If...clinical and Case Management experience. Experience working in a Medicaid Long Term Support Program (LTSS) or Health Home… more
- Molina Healthcare (NY)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB ... + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks +… more
- Humana (Albany, NY)
- …responsible for ensuring the accurate and timely submission of encounter data to Medicaid , Medicare , and DSNP states, while maintaining adherence to all ... Lead is responsible for ensuring the integrity and accuracy of Medicaid and Medicare encounter data across multiple trading partners. This role collaborates with… more
- Catholic Health Services (Rockville Centre, NY)
- …complex data analysis. The ideal candidate possesses in-depth knowledge of Medicare / Medicaid reimbursement, managed care contracts, and healthcare finance. Key ... Responsibilities: + Prepare and review Medicare , Medicaid , and other third-party cost reports, ensuring accuracy and regulatory compliance. + Analyze… more
- Humana (Albany, NY)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Albany, NY)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more