- Sedgwick (Albany, NY)
- …Contacts providers and attorneys to obtain clarification of documentation needed to support the preparation of Medicare Set-Aside allocations. + Creates ... Fortune Best Workplaces in Financial Services & Insurance RN Medicare Compliance Sr **PRIMARY PURPOSE OF THE ROLE:** To...culture. + Passionate about creativity. + Craves culture of support , both giving and receiving. + Thrives when everyone… more
- SUNY Upstate Medical University (Syracuse, NY)
- …management, and available wellness resources. Ensure accurate coding and documentation to support quality initiatives and Medicare compliance. Work closely with ... Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care clinics. This role… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …irregularities; determining continuing needs for Tele-Sale Agents, Benefit Navigators and Medicare Support Specialist. + Ensure all Tele-sale Agents, Benefit ... Navigators, and Medicare Support Specialists are conducting activities that are in compliance with CMS/DOH and company guidelines by directly reporting to the… more
- Molina Healthcare (Yonkers, NY)
- …and within Molina State plans for intervention development and execution to support Medicare Stars measure level improvement and program revenue maximization ... existing healthcare quality improvement initiatives and education programs supporting Medicare Star Ratings improvement for Clinical HEDIS measures. Responsible for… more
- Elevance Health (East Syracuse, NY)
- …to transform federal health programs. The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with the federal government ... and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost...Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A… more
- Humana (Albany, NY)
- …weekend coverage + Develop collaborative relationships with Team and key partners within the Medicare Line of Business. + Support Home Solutions as needed + ... help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare… more
- Community Wellness Partners (Oswego, NY)
- …compliance with GAAP, CMS guidelines, and other healthcare industry accounting standards. + Support Medicare and Medicaid cost report preparation and audits. + ... compliance, and timeliness of financial reporting while providing insight to support operational decision-making. The ideal candidate will have in-depth knowledge of… more
- Centene Corporation (Queens, NY)
- …delivery today. The Manager, Value-Based Payments Initiatives (VBP) will lead and support the expansion and optimization of Medicare -focused VBP arrangements ... managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). The… more
- Humana (Albany, NY)
- …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana… more
- Kelly Services (Fairport, NY)
- …& Health License?** **IF yes, please see this opportunity!** **Kelly(R) is seeking a Medicare Customer Satisfaction Advocate to work at a top insurance client in the ... 6 month project **What's a typical day as a Medicare Customer Service Representative? You'll be:** + Under the...of product questions. + Performing various administrative and member support tasks in line with established policies and procedures.… more
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