- Abbott House (Bronx, NY)
- Job Summary: The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must ... + Medicaid Managed Care policies and procedure + The Medicaid Managed Care Liaison is a full-time position. Duties and Responsibilities: 29I… more
- Molina Healthcare (Yonkers, NY)
- …with Medicaid contract analytics is highly preferred. + Experience working on Managed care analytics and healthcare reimbursement models is required. + Must ... Financial and Utilization Metrics of Healthcare. + Must be able to act as a liaison between Finance and Network Contracting as well as other external teams. + Must… more
- Molina Healthcare (Yonkers, NY)
- …EXPERIENCE** : * 5-7 years of Program and/or Project management experience. * Managed Care experience. * Experience working in a cross functional highly ... Provide credentialing/recredentialing details for monthly/quarterly/semi-annual turnaround time reports to Medicaid agencies as required + Active collaborator with people… more
- City of New York (New York, NY)
- Job Description The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to medically fragile and vulnerable ... daily living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the... Care (MLTC) Program, the Assisted Living Program, Care at Home Program and Homebound Medicaid .… more
- City of New York (New York, NY)
- …OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term ... daily living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the... Care (MLTC) Program, the Assisted Living Program, Care at Home Program and Homebound Medicaid .… more
- Gentiva (Piscataway, NJ)
- … care experience + Knowledge of hospice principles, regulatory compliance, and managed care + Strong communication, collaboration, and organizational skills + ... **Overview** **Lead Compassion. Inspire Excellence. Elevate Hospice Care .** We are seeking a Senior Patient ...to referrals and clinical inquiries + Serve as a liaison between clinical teams, leadership, and external providers +… more
- Molina Healthcare (Brooklyn, NY)
- …worker, Navigator, Assistor, Connecter, Promotora, Marketing, Sales, Growth, New York, MCO, Managed Care , ACA, FQHC, Behavioral Health, CHW, Community Health ... with reliable transportation. **Preferred Experience:** + Solid understanding of Health Care Markets, primarily Medicaid . + Previous healthcare marketing,… more
- Molina Healthcare (Yonkers, NY)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and… more
- Conduent (New Brunswick, NJ)
- …with people representing diverse backgrounds is preferred. **Required skills/abilities:** + Knowledge of Medicaid and managed care programs. + Ability to ... to the Outreach Supervisor and serves as a key liaison between the NJ FamilyCare program and the community....to educate consumers about NJFC and the benefits of managed care within an office and call… more
- New York State Civil Service (New York, NY)
- …Coordination Organizations, Consumer Advisory Board (CAB) advocates, and interface with the Medicaid Compliance Liaison . * Create tickler system to maintain ... Specialist 1 - Quality Management - EOA #2025-219 Occupational Category Health Care , Human/Social Services Salary Grade 14 Bargaining Unit PS&T - Professional,… more
- Molina Healthcare (Yonkers, NY)
- …and applicable software program(s) proficiency. **Preferred Qualifications** * Medicare Part D and/or Medicaid experience. * Managed care experience. To all ... care . **Essential Job Duties** * Acts as a liaison between Molina and its customers (members, providers and...experience in a pharmacy, Pharmacy Benefit Manager(PBM), formulary, and/or managed care setting, and 1-2 years post-graduate… more
- Help at Home (Brooklyn, NY)
- …ensures compliance with New York State Department of Health (DOH) regulations, Managed Long-Term Care (MLTC) program requirements, and Federal guidelines. The ... Home is the leading national provider of in-home personal care services, where our mission is to enable individuals...+ Ensure compliance with DOH regulations, MLTC guidelines, and Medicaid contractual obligations. + Oversee all aspects of client… more
- New York State Civil Service (Staten Island, NY)
- …entries and provide reports to support internal controls* Will serve as liaison between residential managers, residential team leaders and leadership in regard to ... staff utilization* Principal liaison with ERO and HR re: OIL, Administrative Leave,...Dietitian 2, Habilitation Specialist 2, Infection Control Nurse, Intermediate Care Facility Program Manager 1, Intermediate Care … more
- Calvary Hospital (Bronx, NY)
- …by Calvary Hospital. Works cooperatively with other departments, provider referrers and managed care organizations to facilitate the admission of patients to ... the various programs provided by Calvary Hospital. Interfaces with managed care organizations to facilitate reimbursement for services provided by the Hospital.… more
- Mount Sinai Health System (New York, NY)
- …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or ... higher preferred, in analytics development expertise, preferably in health care , or for a health provider, health plan or...Soarian, etc. + Knowledge of the New York State Medicaid and CMS Medicare regulations and related reporting requirements,… more
- Mount Sinai Health System (New York, NY)
- …pharmacy group. 11.Obtains prior authorizations from intermediaries and payers, including managed care companies, insurance companies or others as appropriate. ... including Medicare , Medicaid and TriCare. Preferred: 3 years of health care related billing and benefits investigation 1 year of retail pharmacy experience 1… more
- New York State Civil Service (Queens Village, NY)
- …health care needs. * Maintains ongoing communication with med liaison /designee. * Provides support to residential staff in maintaining health services for ... Disabilities, Office for Title Registered Nurse 1 Occupational Category Health Care , Human/Social Services Salary Grade 18 Bargaining Unit PS&T - Professional,… more
- Molina Healthcare (Yonkers, NY)
- …10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and… more
- Centene Corporation (Queens, NY)
- …federal contracts, related laws, regulations and executive orders. + Deep understanding of managed care models (HMO, PPO, Medicaid , Medicare Advantage, ... + Familiarity with healthcare laws, reimbursement models, and value-based care initiatives. + Perform duties as senior liaison... care initiatives. + Perform duties as senior liaison between product line, other business units, corporate, and… more
- Molina Healthcare (Yonkers, NY)
- …License for workplace and plan location. **Preferred Experience** + Medicare Part D or Medicaid experience. + Managed care experience. To all current Molina ... with questions regarding drug coverage. + Acts as a liaison between Molina and its customers (members, providers and...Case Management department as part of a member-centered interdisciplinary care team. + Works with the PBM to manage… more