- City of New York (New York, NY)
- …DSS AO, the Office of Liens & Trusts (OLT) is responsible for protecting against fraud and recovering Cash Assistance and Medicaid pursuant to SSL 104, 104-b, ... a disabled person with excess resources to shelter their assets and qualify for Medicaid . SNT is recruiting for one (1) Executive Agency Counsel M-II to function as… more
- Commonwealth Care Alliance (Boston, MA)
- …Procedures + Promptly, and in good faith, reports an instances of suspected fraud , waste and abuse; suspected privacy and/or security incidents; or any compliance ... PA) with licensure in good standing in the state served + Role requires Medicaid Enrollment + If works in MA role requires MassHealth Enrollment + Candidate will… more
- AmeriHealth Caritas (Harrisburg, PA)
- …with state regulations and internal standards. A strong understanding of Medicaid , Medicare, and state-funded programs is essential, along with the ability ... Office of Mental Health & Substance Abuse Services (OMHSAS), supporting Medicaid enrollment and documentation processes. + Coordinate with internal departments to… more
- MyFlorida (Orlando, FL)
- …obtain and verify information needed to determine eligibility for Food Assistance, Medicaid , and Cash Assistance. + Learning numerous state and federal program ... regarding eligibility status is confirmed. + Reporting cases where identity theft or fraud is suspected. + Advising clients of deadlines, time frames, and necessary… more
- State of Colorado (Pueblo, CO)
- …Accreditation Standards, Environment of Care Manual, Centers for Medicare and Medicaid Services, Safety Data Sheets, Colorado State Personnel Procedure Manual, ... personnel.) + CBI & FBI fingerprint check, Colorado Court Database check, Medicare Fraud Database, TRAILS Database check. + This position will also provide direct… more
- LA Care Health Plan (Los Angeles, CA)
- …analytics and decision support. Direct experience with AI and ML in the Medicaid , Medicare and Marketplace markets. Skills Required: Ability to develop and apply ... Inference, Big Data Processing & Integration, Statistical Control Processes, Claims Fraud , Waste & Abuse (FWA), Population Health Strategies Physical Requirements… more
- RWJBarnabas Health (West Orange, NJ)
- …issues relating to payor relationships, third-party administrators, Medicare Advantage, and Medicaid Managed Care. This position requires at least 8 years of ... on value-based care models and alternative payment arrangements in accordance with fraud and abuse laws, including the federal Anti-Kickback Statute, Stark Law, and… more
- MyFlorida (Tallahassee, FL)
- …of Public Benefits Integrity (OPBI) is responsible for investigating public assistance fraud or misuse regarding the SNAP (Food Assistance), D-SNAP (Disaster Food ... Assistance), TANF (Cash Assistance), and Medicaid programs by individuals or merchants. OPBI is also responsible for quality assurance and quality control of the… more
- Banner Health (Phoenix, AZ)
- …QUALIFICATIONS Specialized knowledge of insurance and health law, including Stark, fraud and abuse, HIPAA, medical staff relationships, managed care contracting, ... provider networks and value-based care; specialized knowledge of Medicare and Medicaid . Transactional experience with mergers and acquisitions, joint ventures, and… more
- City of New York (New York, NY)
- …in a timely and efficient manner while reducing the risk of worker and client fraud . Creates and develops processes and sets policy for the implementation of new and ... temporary cash assistance, Supplemental Nutrition Assistance Program (SNAP) benefits, Medicaid , and employment services to eligible individuals and families in… more