- Molina Healthcare (New York, NY)
- …appeals and supporting market performance. Performance activities include physician auditing, training, and performance improvement activities. Additionally, they ... medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred… more
- Evolent (Albany, NY)
- …and management staff as well as health plan members and staff whenever a physician `s input is needed or required. Responsible for clinical audits for quality and ... for improvement. Responsible for coordinating education and findings with matrixed Physician Business Manager. + Provides medical direction to the support services… more
- Surgery Care Affiliates (New York, NY)
- …for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a ... accurate verification and eligibility. This step may require direct contact with the physician office and/or the patient. + Determine if a secondary insurance should… more
- Northwell Health (Garden City, NY)
- …online resources: Official Coding Guidelines (OCG), AHA Coding Clinic, Center for Medicare Services and CPT Assistant) to identify appropriate codes and reference ... for all records as required and in accordance with the Centers for Medicare and Medicaid Services (CMS) rules and regulations. 7.Make determinations on medical… more
- Guthrie (Binghamton, NY)
- …populations through nursing-patient collaboration and patient education. This nurse performs the Medicare Annual Wellness Visit under the direct supervision of a ... physician ( physician on site) for beneficiaries to...illness prevention strategies. + Performs all elements of the Medicare AWV with beneficiaries in accordance with Documentation Standards… more
- Cardinal Health (Albany, NY)
- …Summary** Senior executive leader responsible for leading all aspects of Navista's Physician Office's revenue cycle, managed care and value based care programs and ... responsibilities include optimizing the revenue cycle to create financial stability to physician offices, develop short and long term strategic plans for manage care… more
- Guthrie (Cortland, NY)
- …the implementation and oversight of clinical requirements developed by the Center for Medicare and Medicaid (CMS), the Department of Health (DOH), and The Joint ... Program is to ensure that the policies and practices of the physician -based outpatient offices comply with the requirements of external organizations that regulate… more
- SUNY Upstate Medical University (Syracuse, NY)
- …consultations. Minimum Qualifications: Master's Degree as a Nurse Practitioner or Physician Assistant. NYS licensed/registered NP or PA required. Current National ... the clinical practice also required. Have a NPI number and be Medicare enrolled with a Medicare Identification Number (or PTAN) (or eligible for Medicare … more
- SUNY Upstate Medical University (Syracuse, NY)
- …and procedures. Minimum Qualifications: + Master's Degree as a Nurse Practitioner or Physician Assistant (or graduated from an accredited PA program) or will be ... to the clinical practice. + Have a NPI number and be Medicare enrolled with a Medicare Identification Number (or PTAN) (or eligible for Medicare Enrollment… more
- SUNY Upstate Medical University (Syracuse, NY)
- …and procedures. Minimum Qualifications: + Master's Degree as a Nurse Practitioner or Physician Assistant (or graduated from an accredited PA program) or will be ... to the clinical practice. + Have a NPI number and be Medicare enrolled with a Medicare Identification Number (or PTAN) (or eligible for Medicare Enrollment… more