- New York State Civil Service (Queens Village, NY)
- …maintain eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification and Medicaid ... maintain eligibility for full and unconditional participation in the Medicaid and Medicare programs. Failure to maintain licensure, certification and Medicaid… more
- New York State Civil Service (West Seneca, NY)
- …Participate in 1st & 2nd Step Reviews, as assigned.* Provide backup support for eligibility Medicaid Fair Hearings * Provide assistance with triage of ... using NYS Mental Hygiene Law and OPWDD guidelines.* Participate in the Medicaid Fair Hearing process regarding Eligibility ; this includes preparing, reviewing,… more
- City of New York (New York, NY)
- …for clients and their representatives to address problems or complaints related to Medicaid eligibility decisions, with the goal of reducing the number of ... - York State Department of Social Service regulation. - Review determinations on Medicaid eligibility made by lower-level supervisors in Hoepita1 eligibility … more
- Serco (VA)
- …quantitative research on government health programs (such as Marketplace, Medicare, Medicaid ). + Minimum 3 years management experience. Desired Qualifications: ... onthe potential impact of federal and state health policy onthe CMS Eligibility Support (ES) Program, which processes eligibility verification for program… more
- Sanford Health (Sioux Falls, SD)
- …of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure compliance ... the department in monitoring the utilization of resources, risk management and quality of care for patients in accordance...and local coverage determinations (NCD/LCD), centers for Medicare and Medicaid services (CMS), as well as state and federal… more
- CVS Health (Columbus, OH)
- …of the bold vision to deliver the "Next Generation" of managed care in Ohio Medicaid , Ohio RISE will help struggling children and their families by focusing on the ... in, multiple child-serving systems. For the OhioRISE Program, the Quality Management Nurse Consultant position is responsible for the following job functions… more
- New York State Civil Service (Rochester, NY)
- …State NY Zip Code 14620 Duties Description Supervise and oversee Health Information Management and Medicaid Compliance. Duties include but are not limited to:* ... the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility .* If you are employed by state government you may be able to… more
- Humana (Springfield, IL)
- …Services Lead who is dedicated full-time to member services for the Illinois Medicaid Market. This Lead leverages the voice of the customer, root cause, telling ... of member grievance and appeal trends, working closely with cross-departmental management . + Partners across consumer services areas ensuring excellence with… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …seeking a highly skilled and dynamicAccountant Manager 3to oversee and elevate critical Medicaid revenue functions within our Cash Management Section. This role ... or banking; OR A bachelor's degree in accounting, finance, business administration, management , economics, or statistics plus five years of experience in accounting,… more
- New York State Civil Service (NY)
- …the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility .* If you are employed by state government you may be able to ... or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any...to verify your identity. Name Finger Lakes Human Resources Management Office - Posting Department Telephone ### Fax ###… more