- Centene Corporation (Queens, NY)
- …department including negotiations and administering organization policies and procedures. + Lead and inspire a high-performing team , fostering a collaborative ... development, succession planning, and performance excellence to build a strong, adaptable team for the future. + Experience with provider performance in cost of… more
- Living Resources (Albany, NY)
- …with disabilities and special needs the support they need to thrive and lead active, full lives. For many Living Resources employees, their work becomes an ... behalf of the participant. + Fiscal accounting and reporting. + Ensure Medicaid and corporate compliance. + General administrative supports. + Verify staff… more
- Trinity Health (Sharon Hill, PA)
- …supports the entire enrollment process, from initial referral to eligibility assessment, ensuring accurate documentation and seamless communication between ... participants and the interdisciplinary team . Position Highlights and Benefits: . Day-1 Benefits (Low-cost medical, dental, and vision insurance plans). . Opportunity… more
- Mohawk Valley Health System (Utica, NY)
- …effective and efficient utilization of resources. The Physician Advisor guides the team to improve clinical and financial outcomes with documentation and clinical ... the assigned/estimated GMLOS + Partner with the care management team with the management of LOS, complex care needs...medical staff. + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. Act… more
- Dartmouth Health (Bennington, VT)
- …Hospital Medicine Dartmouth Hitchcock Clinic is seeking a Medical Director to lead our Hospital Medicine service at Southwestern Vermont Medical Center (SVMC) in ... practice providers. SVMC provides a great culture and collaborative team environment. The average daily census is 45 and...and relocation stipend may also be available, subject to eligibility . SVMC is an integrated, non-profit health system with… more
- CVS Health (Columbus, OH)
- …is a key member of Aetna's Medical Policy and Program Solutions (MPPS) team . This individual contributor will provide clinical project management support, policy and ... of Utilization Management initiatives, determining ROI and annual review processes + Lead and support SAI (scorable action items) projects; responsible for strategic… more
- Care Initiatives (West Des Moines, IA)
- …willingness to take on challenges approach, you'll be well equipped to successfully lead a skilled nursing community (SNF) once licensed. Our program rotates you ... regulations set forth by The Centers for Medicare and Medicaid Services (CMS) and the state of Iowa to...you taking additional classes in order to meet state eligibility requirements. + MHA, MBA, or advanced degree is… more
- Trinity Health (Newtown, PA)
- …for an experienced Radiology Scheduling Specialist to join our Patient Access team !_** **Employment Type:** Full Time **Shift:** 40hrs/wk, days **M-Th 9a-5:30p and F ... Specialist is responsible for pre-registration, scheduling, electronically verifying insurance eligibility and accurately identifying patient financial responsibility. Position handles… more
- Healthfirst (NY)
- …on memberships, data integrity and address discrepancies related to member eligibility and enrollment. + Manage premium billing cycles, invoice generation, and ... compliance with State and CMS guidelines and to ensure member satisfaction + Lead cross functional risk assessment root cause analysis activities to identify, assess… more
- Trinity Health (Fort Lauderdale, FL)
- …all necessary reports. + Communicate with Case Management, Patient Financial Services and Self/Pay/ Medicaid eligibility Team and all other departments when ... way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce… more