- buyer (New York, NY)
- …list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus ... building strong relationships with its members and providers.Position OverviewThe Senior Director of IT Core Systems is responsible for evaluating operational… more
- buyer (New York, NY)
- …list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus ... is shared with the leadership team for the purpose of meeting program goals and the implementation of continuous quality improvement strategies. The Medicare… more
- HealthCare Support (Houston, TX)
- …approved medical guidelines. Refers cases that do not meet criteria to Medical Director for review. 2. Assists in discharge planning especially Home Health Nursing ... of these services and if not meeting criteria, refer to the Medical Director . 3. Participates in Community Nursing Rounds if applicable with Medical Director… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …Directs program reviews and quality assurance effortsto monitor effectiveness, ensure program integrity , reduce error rates, and safeguard federal funding. + ... DEPUTY DIRECTOR OF ELIGIBILITY ( MEDICAID DEPUTY ...Medicaid Eligibility Division and Louisiana Children's Health Insurance Program (LaCHIP), ensuring access to essential medical services for… more
- City of New York (New York, NY)
- …Within DSS-AO, resides an area called the Office of Quality Assurance & Fiscal Integrity , the Medicaid Quality Control Unit (MAQC). They conduct complex internal ... DSS Accountability Office (DSS-AO) is responsible for protecting the integrity of social services programs administered by the New...Reviewers in their eligibility review findings. - Assist the Medicaid Audit and Quality Control director with… more
- New York State Civil Service (Syracuse, NY)
- …ensuring the financial integrity of New York state's $96 billion Medicaid program by investigating healthcare providers, such as pharmaceutical companies, ... legal support analysts to conduct complex, long-term healthcare fraud investigations. The Medicaid program provides health coverage to millions of New Yorkers,… more
- New York State Civil Service (New York, NY)
- …ensuring the financial integrity of New York state's $96 billion Medicaid program by investigating healthcare providers, such as pharmaceutical companies, ... legal support analysts to conduct complex, long-term healthcare fraud investigations. The Medicaid program provides health coverage to millions of New Yorkers,… more
- Commonwealth Care Alliance (Boston, MA)
- …will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a ... scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the… more
- City of New York (New York, NY)
- Job Description The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs, for the City of New York. Applying ... areas: Managed Care Client Services (MCCS), Recipient Restriction Program (RRP), and Comprehensive Medicaid Case Management...state managed care enrollment broker for the managed care program ) to ensure the operational integrity of… more
- Diversicare Healthcare Services & Diversicare Ther (Jackson, MS)
- …RAI process + Identification and resolution of data integrity issues + Medicare, Medicaid and Managed Care program requirements + Medicare, Managed Care and ... RAI, Medicare, Medicaid and Managed Care processes to facilitate compliance, integrity and accurate reimbursement. 2. Train and consult with center staff and… more
- CVS Health (Springfield, IL)
- …CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director (Medical Affairs). This is a remote based, work from home opportunity. The ... Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director (Medical Affairs) will report into the Medical Affairs Department… more
- City of New York (New York, NY)
- …for Medicare, identifying Medicaid clients who should be part of buy-in program , and identifying SDOH Medicaid clients who should no longer have benefits. ... Services Accountability Office (DSS-AO) is responsible for supporting the integrity of social services programs administered by the New...Staff Analyst NM III to function as an Executive Director , Data Analytics & Verification who will: - Oversee… more
- The Arc Erie County NY (Williamsville, NY)
- …for over 65 years. Position Now Available at The Arc Erie County NY: Associate Director (AD) of Outreach Full Time, 40 hours per week, Monday - Friday Overview The ... not for profit local agency helping people with developmental disabilities. Our Associate Director of Outreach position plays a key leadership role in managing and… more
- HCA Healthcare (Myrtle Beach, SC)
- …At HCA Healthcare, we are committed to caring for patients with purpose and integrity . We care like family! Jump-start your career as a Patient Access Assistant ... Director today with Grand Strand Medical Center. **Benefits** Grand...student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program … more
- Molina Healthcare (Ann Arbor, MI)
- …and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality ... of the criteria for medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the… more
- Molina Healthcare (Layton, UT)
- …and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality ... of the criteria for medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the… more
- Advancing Beyond the Spectrum (Eldersburg, MD)
- LOCATION: Center Director (BCBA), Eldersburg, MD (PLUS A SIGN-ON BONUS) Why Choose Advancing Beyond the Spectrum? + Opportunity to earn up to $24,000 annually ... our clients and our communities. JOB SUMMARY The Center Director is a Board-Certified Behavior Analyst (BCBA) and the...as a Lead BCBA, to ensure clinical progress, treatment integrity , and alignment with individualized goals. + Lead center-wide… more
- Care Initiatives (West Des Moines, IA)
- …+ Audit and monitor integrity of: + Overall RAI process + Medicare, Medicaid , VA and Managed Care program requirements + PDPM Management + Complete Data ... Care Initiatives is seeking a Director of Clinical Reimbursement. As the largest single...knowledge of MDS/RAI, Medicare reimbursement, PDPM systems, compliance and Medicaid Clinical Reimbursement RUGS/CMI. + Remote position with ability… more
- HCA Healthcare (Weatherford, TX)
- …HCA Healthcare, we are committed to caring for patients with purpose and integrity . We care like family! Jump-start your career as a(an) Health Information ... Management Director today with Medical City Weatherford. **Benefits** Medical City...student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program … more
- HCA Healthcare (Aurora, CO)
- …At HCA Healthcare, we are committed to caring for patients with purpose and integrity . We care like family! Jump-start your career as a Patient Access Director ... student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program ...location._** Come join our team as a Patient Access Director . We care for our community! Just last year,… more
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