- Independent Health (Buffalo, NY)
- …and statistical analyses, specifically designed to support pricing and bidding for Medicare Advantage plans. Such projects will support both internal and external ... to assess impacts on pricing outcomes. + Establish and implement claims review processes to support risk adjustment. Analyze data and provide strategic insights… more
- CUNY (New York, NY)
- …update and enter employee retirement dates into the system for Medicare reimbursements and lump sum annual leave payments **QUALIFICATIONS** Bachelor's Degree ... ONE single file-- PDF format preferred.** **CLOSING DATE** Open until filled with review to begin in 21 days **JOB SEARCH CATEGORY** CUNY Job Posting:… more
- Healthfirst (NY)
- …the care plan for assigned members and conducts pre-certification, concurrent review , discharge planning, and case management as assigned. The Case Manager, ... Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of Centers for Medicare & Medicaid Services (CMS) or New York State + Department of Health… more
- Mount Sinai Health System (New York, NY)
- …party payers, accrediting bodies, insurance /PBM companies, government peer review organizations, accrediting bodies,external partners, and referring physicians. The ... procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: 3 years of health care… more
- YAI (Manhattan, NY)
- …agencies (Office for People with Developmental Disabilities (OPWDD), Centers for Medicare and Medicaid Services (CMS), Office of Medicaid Inspector General (OMIG), ... assigned. + Regularly collaborates with YAI support teams and operations to review /ensure compliance with relevant YAI, State and Federal requirements. + Attends… more
- New York State Civil Service (Vestal, NY)
- …psychology, research psychology, industrial psychology, organizational psychology, utilization review , guidance counseling, etc. Additional Comments This title is ... and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility.… more
- New York State Civil Service (Mohegan Lake, NY)
- …day program, IES, residential staff.* Annually for everyone in your caseload, completes review of medical section ISP, medication audit (each home)* Keeps up to date ... and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining… more
- University of Rochester (Rochester, NY)
- …purposes. Assures completion of all appropriate forms by patients, such as, Medicare Secondary Payer assurance, provision of HIPAA information for new patients, ... verification, and/or service authorization in advance of treatment through review of dental insurance benefits and requirements. Maintains working knowledge… more
- University of Rochester (Rochester, NY)
- …drugs (HazD) in compliance with USP 800 standards, Centers for Medicare and Medicaid Services┐ Conditions of Participation, Department of Health regulations, ... it relates to HazD handling and utilization within the health system. Documents the review of the quality assurance program and findings on at least annually in the… more
- University of Rochester (Rochester, NY)
- …+ Ensures completion of all appropriate forms by patients, such as Medicare Secondary Payer assurance, provision of HIPAA information for new patients, requesting ... verification, and/or service authorization in advance of treatment through a review of dental insurance benefits and requirements. + Maintains working knowledge… more