- CVS Health (NY)
- …And we do it all with heart, each and every day. **Position Summary** The ** Medicare Compliance Consultant ** is a compliance role that supports ... partnership with - and under the direction of - the health plan, Medicare Compliance Officer, and other team members, this position will help develop and… more
- Humana (Albany, NY)
- …Adhere to established guidelines and procedures to ensure consistency and compliance . **Potential Duties** + Advocate for our agile development approach and ... with the organization's strategy and long-term goals. + Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that… more
- Ellis Medicine (Schenectady, NY)
- …as well as, the high risk population, chronic medical problems, non- compliance issues, interdisciplinary and/or patient, family, requests + Participates in ... of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or discharge...+ Coordinates acute hospital to hospital transfers to ensure compliance with all the discharge planning regulations and transfer… more
- Humana (Albany, NY)
- …through collaboration with diverse stakeholders across the enterprise, including legal, compliance , education, and IT. In this role, you will contribute to ... the enterprise, including model risk assessments, fairness evaluations, and compliance with ethical and regulatory standards. Champion transparency, accountability,… more
- Arnot Health (Elmira, NY)
- …Description MAIN FUNCTION: The Clinical Accreditation Specialist acts as a consultant on interpretation of regulatory standards, including The Joint Commission and ... Centers for Medicare and Medicaid Services (CMS); ensures a constant state...leadership and assistance to enterprise-wide initiatives. Performance Improvement and Compliance : Duties and Responsibilities: ** 1. Assumes the daily… more
- CVS Health (NY)
- …chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative ... using clinical tools and information/data. Utilizes case management processes in compliance with regulatory and company policies and procedures. - Facilitates… more
- Catholic Health Services (Roslyn, NY)
- …on Long Island to receive a five-star rating from the Centers for Medicare & Medicaid Services for consistently high patient satisfaction scores Job Details Critical ... measures. + Serve as a clinical expert and leadership consultant to members of the healthcare team and to...the larger community. + Participate in and support accreditation, compliance , and regulatory activities of the organization. + Identify… more
- Catholic Health Services (West Islip, NY)
- …most advantageous clinical and financial outcomes. + Supports all CH and consultant initiatives addressing activities relative to Care Management and Denials. + ... Coordination department, Medical Staff, and SCSH Administrative Staff. + Ensures compliance with Hospital Conditions of Participation. + Implements care management… more