- Hannaford (Schodack Landing, NY)
- …of integrity, professionalism, and confidentiality. * Authorization to fill Medicare and Medicaid prescriptions. ESSENTIAL JOB FUNCTIONS: 1. Process prescriptions ... are conveyed to all associates and completed daily or as necessary. 22. Review and respond to emails as needed. PHYSICAL REQUIREMENTS: 1. Stand 100% of… more
- Veterans Affairs, Veterans Health Administration (Castle Point, NY)
- …are required based on DRG/ALOS or type of care provided outside the Medicare Rate. This position includes payment reconciling for Community Care medical claims ... coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability utilization to ensure that clinic schedules are… more
- Humana (Albany, NY)
- …support of state-level initiatives. + Supports Medicaid IT leadership in preparing readiness review materials. + Acts as a point of delivery escalation for their ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Actalent (New York, NY)
- …to grow within managed care + Gain experience working with Medicare REQUIREMENTS: + California pharmacy technician license OR national pharmacy technician ... determination requests submitted from providers and determine if a pharmacist review is required + Obtain verbal authorizations and request detailed clinical… more
- CenterWell (Albany, NY)
- …services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources. + ... Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services + Participates in special projects and performs other… more
- Insight Global (New York, NY)
- …specializes in health technology and provides remote patient monitoring to Medicare populations - specifically those with chronic illnesses (ex. Type2 diabetes, ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- Northern Rivers Family Services (Albany, NY)
- …for which provide billable services or are required to register with Medicaid/ Medicare based on their credential, department and position. + Work with organizational ... CFO with weekly report of status of credentialing by program/provider for review with Chiefs. + Monitor license and credential expiration dates, provider electronic… more
- Northwell Health (Lake Success, NY)
- …of care provided. Responsible for concurrent inpatient medical record reviews for Medicare , Medicaid and all commercial payers. Generates queries and have follow up ... clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests clarification of… more
- Humana (Albany, NY)
- …meet required timelines. + Submits required documents to state agencies for review and approval. + Regularly meet with Humana Healthy Horizons Medicaid markets ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- New York State Civil Service (Staten Island, NY)
- …program area.* Write responses to correspondence.* Resolve work problems.* Review forms and applications and make appropriate determinations.* Coordinate ... and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining… more