- Evolent (Albany, NY)
- …with leadership, management, and clinical staff to address complex cases and support decision-making. + Act as a key resource for Initial Clinical Reviewers, ... to the Utilization Management process, interpretation, guidelines and/or system support . + On a requested basis, may function as...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Project Renewal, Inc. (New York, NY)
- …are not limited to the following activities: + Compliance Program Management + Support the Director of Legal Affairs and Compliance in executing and enhancing the ... with federal, state, and local healthcare regulations (eg, HIPAA, Stark Law, Medicaid/ Medicare , Part 2). + Ensure the organization's compliance program meets FQHC… more
- Molina Healthcare (NY)
- …Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing ... applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA...is easy to understand and provides insights needed to support strategic investment decisions + Research and develop reports… more
- New York State Civil Service (Ovid, NY)
- …eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification and Medicaid/ Medicare ... York State Office of Addiction Services and Supports (OASAS) is to provide, support , and oversee a data-driven continuum of addiction services delivered with equity,… more
- WMCHealth (Hawthorne, NY)
- …NorthEast Provider Solutions Inc. City/State: Hawthorne, NY Category: Clerical/Administrative Support Department: Business Office Union: No Position: Full Time ... Specialist - Provider Enrollment position is responsible for providing administrative support for the process of payer enrollment credentialing for the medical… more
- New York State Civil Service (Ogdensburg, NY)
- …eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain Medicaid/ Medicare eligibility will result ... York State Office of Addiction Services and Supports (OASAS) is to provide, support , and oversee a data-driven continuum of addiction services delivered with equity,… more
- Albany Medical Center (Albany, NY)
- …Manage multifaceted projects using formal management tools. + Establish departmental controls that support and guide the mission and vision of the laboratory and the ... the Correct Coding Initiative, charge submission protocols, and current Medicare regulations. + Collect and analyze data relating to...to other hospital EHR systems + Working knowledge of Medicare rules and edit. CCI, OCE, APC, MUE, and… more
- Evolent (Albany, NY)
- …to the Utilization Management process, interpretation, guidelines and/or system support . + Participates in on-going training per inter-rater reliability process. ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- New York State Civil Service (Batavia, NY)
- …projections, capital outlay and fixed assets schedules, and Medicaid & Medicare reimbursement activities for the facility.* Develops, implements, reviews, and ... data to develop budget estimates, ensure appropriate use of funds, support financially sound budgetary decisions, and maximize revenues.* Reviews financial ledgers… more
- Trinity Health (Schenectady, NY)
- …Care for the Elderly (PACE)--a unique model that is both the Medicare /Medicaid insurer and healthcare provider--giving us maximum ability to customize services to ... are at full risk, with the ability to combine Medicare and Medicaid resources to provide care in creative...yo and above who have needs for long term support in the community. As a healthcare provider, we… more