- Molina Healthcare (Yonkers, NY)
- …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
- Molina Healthcare (Yonkers, NY)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (Yonkers, NY)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (Yonkers, NY)
- …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
- Molina Healthcare (Yonkers, NY)
- …and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's ... for leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible...DSNP, HIDE, FIDE, EAE, AIP, etc. * Provides direct oversight , monitoring and training of provider disputes and appeals… more
- Centene Corporation (Queens, NY)
- …is critical in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special Needs Plans ... incentive programs, attribution logic, and provider engagement strategies. + Represent Medicare VBP in governance discussions and escalate operational issues… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …researching on real-world evidence, and creating hope for all facing illness. The Associate Director of Market Access Services will be a key contributor to a team ... and PAP. This role will report directly to the Director of Trade & Market Access Strategy and be...Market Access Strategy and be responsible for the daily oversight of all patient access and support services as… more
- WTW (Fort Lee, NJ)
- …insurance brands in the US This role requires both strategic vision and operational management, with direct oversight of campaign planning, optimization, and ... leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental… more
- The New Jewish Home (Bronx, NY)
- …The HAPI Division of The New Jewish Home is seeking for a full time Director of Patient Care to join our team. Job Summary: Oversees all clinical operations, ... of quality metrics to support performance improvement initiatives and quality/compliance oversight . o Serves as quality subject matter expert with other stakeholders… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Billing Director -Patient Financial Services- Corporate (ON SITE) Full-Time -Days** Responsible for direction and management responsibility over ... the business and operational activities of a department or medical care unit....training materials and train employees when necessary. + Provides oversight to management staff to ensure compliance with established… more