- Centers Plan for Healthy Living (Staten Island, NY)
- …and identifying any deficiencies. + Prepare summaries for management of quality review results, including basic analysis of identified trends. + Analyzes audit ... Experience Required: 2+ years of claim processing experience with a Medicaid/ Medicare Health Plan. Preferred: Experience in health insurance product environment.… more
- New York State Civil Service (NY)
- …of plan of care.* Participate in psychiatric peer review meetings as well as specialized team meetings.LinkedIn: ... and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining… more
- Mohawk Valley Health System (Utica, NY)
- …Protection Agency (EPA), National Fire Protection Association (NFPA), Centers for Medicare & Medicaid Services (CMS), and Department of Homeland Security (DHS) ... the hospital accreditation body (eg, DOH, DNV-GL). + Establish mechanisms to collect, review , and track data required by local, state, and federal entities. +… more
- Highland Hospital (Rochester, NY)
- …information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and ... assessment or Financial Assistance, reviews and validates MSP questions, monitors Medicare days for exhausted benefits, identifies and resolves coordination of… more
- Lakeview Health Services (Geneva, NY)
- …and objectives. + Develop and revise support services plans upon enrollment, review every 6 months, and following significant changes in functioning/life events, if ... + Assist with linkage to benefits to include but not limited to: + Medicaid/ Medicare + SSI/SSD + Public Assistance + Link individuals with community resources +… more
- Kaleida Health (Buffalo, NY)
- …provides reimbursement planning and is responsible for key decision-making related to Medicare , Medicaid, and other Third Party Payors to ensure payment. Provides ... - Sedentary (10 lbs)** **Job Details** Department: HPTE SNF Utilization Review Standard Hours Bi-Weekly: 75.00 Weekend/Holiday Requirement: No On Call Required:… more
- Molina Healthcare (NY)
- …MTM Pharmacy Services staff work to ensure that Molina members have access to Medicare Star medications and those meds are used in a cost-effective, safe manner. ... clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing… more
- Arnot Health (Elmira, NY)
- …interpretation of regulatory standards, including The Joint Commission and Centers for Medicare and Medicaid Services (CMS); ensures a constant state of readiness; ... and expertise to hospital administration's policy and procedure committee with scheduled review and update to appropriate policies and access to all relevant… more
- New York State Civil Service (Queens Village, NY)
- …treatment plans that include goals and objectives.* Participating in case review to present clinical observations and suggest treatment programs.* Conducting ... individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program.)… more
- New York State Civil Service (Tupper Lake, NY)
- …of plan of care.* Participate in psychiatric peer review meetings as well as specialized team meetings.LinkedIn: ... and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility.… more