- Molina Healthcare (Albany, NY)
- …Leads and directs team that provides strategic, process improvements, and operational support to advance the goals and objectives of the Integrated Duals program. ... Affairs to assess and provide analyses for proposed changes to Medicare , and other government-sponsored healthcare program contracts, governing regulations and new… more
- Molina Healthcare (Yonkers, NY)
- …PST hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving member and ... with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research… more
- Staffing Solutions Organization (Albany, NY)
- …& Marketplace Integration (DEMI)** **Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries** **Telecommuting Option:** This position is ... from a variety of sources such as Centers for Medicare and Medicaid Services (CMS), Insurance Carriers, and others....have access to their own wireless internet (WiFi) to support consistent and secure connectivity. + **System Functionality:** The… more
- Humana (Albany, NY)
- …established clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be passionate about ... its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage… more
- Humana (Albany, NY)
- …clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate about contributing ... its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage… more
- Molina Healthcare (Syracuse, NY)
- …the organization and outsourced vendor work. The Sr. Analyst providers peer level support to Analysts in the department through training and guidance on audits and ... federal regulatory rules, contracts, and other guidance to assess compliance and support building regulatory compliance audit procedures. * At the direction of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Supervisor IV-Patient Financial Services ( Medicare and Medicaid Claims Follow-Up) Corporate- Full-Time Days Responsible for the supervision and ... and practices. Provides direct supervision for administrative and office support staff such as secretarial/administrative assistants, medical assistants, schedulers,… more
- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... maintain risk score models. + Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting. + Extract and… more
- Molina Healthcare (Buffalo, NY)
- …pharmacy technicians, pharmacy service representatives, and/or pharmacy internal monitors who support processes involved with the review of non-formulary drugs or ... speed to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. + Ensures that adequate staffing coverage is… more
- Healthfirst (Enfield, NY)
- …implementation throughout the year. + Assist with corporate initiatives related to Medicare quality or STAR ratings- ie HRAs/FPL/MSP. + Successfully pass audit ... multiple marketing locations + Ability to collaborate with internal stakeholders and support teams for cross-referral and joint promotions + Ability to use… more