• Legal Nurse/Medical Analyst: Medicaid Fraud…

    New York State Civil Service (New York, NY)
    …legal support analysts to conduct complex, long-term healthcare fraud investigations. The Medicaid program provides health coverage to millions of New Yorkers, ... to resident abuse, mistreatment, or neglect, as well as quality assurance issues; * Case management , MDS...of state and federal rules and regulations related to health care, particularly the Medicaid program. Additional… more
    New York State Civil Service (05/14/25)
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  • Medical Director Specialty Medical Services…

    Molina Healthcare (New York, NY)
    …director, and quality improvement staff. + Facilitates conformance to Medicare, Medicaid , NCQA and other regulatory requirements. + Reviews quality referred ... development, provider contracting experience. + Experience with NCQA, HEDIS, Medicaid , Medicare and Pharmacy benefit management , Group/IPA practice,… more
    Molina Healthcare (04/11/25)
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  • Supervisor IV-Patient Financial Services (Medicare…

    Mount Sinai Health System (New York, NY)
    **Job Description** Supervisor IV-Patient Financial Services (Medicare and Medicaid Claims Follow-Up) Corporate- Full-Time Days Responsible for the supervision and ... staff such as secretarial/administrative assistants, medical assistants, schedulers, data management and medical records staff. Ensures successful delivery of… more
    Mount Sinai Health System (04/28/25)
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  • Executive Director, Office of Mail Renewal (OMR),…

    City of New York (New York, NY)
    …Care Organizations (MCOs) and case management providers through which eligible Medicaid clients access behavioral and health care services. MCP is comprised ... Job Description The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs, for the City of New York. Applying… more
    City of New York (05/14/25)
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  • Healthcare Payment & Financing Innovation Senior…

    City of New York (New York, NY)
    …maternal mortality and morbidity Lead efforts to maximize impact of the 2022-2027 NYS Medicaid 1115 Waiver on public health outcomes. - Lead managed care ... collaboration initiatives for COVID-19 management and recovery in partnership with Medicaid ...Medicaid and Medicare enrollees. - Advance adoption of health insurance payment innovation initiatives such as guarantees of… more
    City of New York (05/25/25)
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  • Quality Management Coordinator

    City of New York (New York, NY)
    Management Coordinator who will: - Develop and implement a quality management system for medical and behavioral health services, Health Services ... as Cash, Food and Rental Assistance as well as Medicaid . The DSS Medical and Health Services...qualitative and quantitative data entry. - Create a clinical quality management program in collaboration with other… more
    City of New York (03/22/25)
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  • Inpatient Coding Quality Officer III…

    RWJBarnabas Health (Oceanport, NJ)
    …Officer III - (Medicare)Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:HIM - Coding Quality ... Choosing RWJBarnabas Health ! RWJBarnabas Health is the premier health care destination providing patient-centered, high- quality academic medicine in a… more
    RWJBarnabas Health (03/21/25)
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  • Director, Corporate Reimbursement (Hybrid/Remote)

    RWJBarnabas Health (Oceanport, NJ)
    …Reimbursement (Hybrid/Remote) - Oceanport, NJReq #:0000180233 Category:Professional / Management Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate ... Choosing RWJBarnabas Health ! RWJBarnabas Health is the premier health care destination providing patient-centered, high- quality academic medicine in a… more
    RWJBarnabas Health (03/21/25)
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  • Nurse Practitioner Care Management

    Hackensack Meridian Health (Brick, NJ)
    …held accountable for their performance. They will be an integral part of the Care Management / Population Health team. Holds a minimum of a Master's degree and ... of entering position. Licenses and Certifications Preferred: 1. Medicare Certification and Medicaid Certification. 162009 HACKENSACK MERIDIAN HEALTH (HMH) IS AN… more
    Hackensack Meridian Health (04/22/25)
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  • Data Science Analyst III-MSH - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …and analytic development skills and impact the patient community of the Mount Sinai Health System. Serves as mentor to others in the Data Science team and takes ... minimum, higher preferred, in analytics development expertise, preferably in health care, or for a health provider,...Soarian, etc. + Knowledge of the New York State Medicaid and CMS Medicare regulations and related reporting requirements,… more
    Mount Sinai Health System (05/10/25)
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  • Senior Contract Manager Analyst - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …of patients. We are accelerating a transition to a business model focused on population health management - our goal is to keep entire communities healthy and ... Description** Mount Sinai is one of the largest US health systems with a strong reputation for quality...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
    Mount Sinai Health System (04/17/25)
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  • Specialty Pharmacy Financial Access Coordinator,…

    Mount Sinai Health System (New York, NY)
    …proficiency in the procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare. Preferred: ... to prior authorization of specialty medications, oversight of the quality of work done in key department systems, support...3+ years of retail pharmacy technician experience or related health care administrative, and a strong familiarity with the… more
    Mount Sinai Health System (03/12/25)
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  • Senior Contracting Analyst - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …of patients. We are accelerating a transition to a business model focused on population health management - our goal is to keep entire communities healthy and ... Description** Mount Sinai is one of the largest US health systems with a strong reputation for quality...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
    Mount Sinai Health System (04/04/25)
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  • Senior Contracting Compliance Analyst…

    Mount Sinai Health System (New York, NY)
    …of patients. We are accelerating a transition to a business model focused on population health management - our goal is to keep entire communities healthy and ... Description** Mount Sinai is one of the largest US health systems with a strong reputation for quality...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
    Mount Sinai Health System (04/09/25)
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  • Patient Accounts Manager (Billing Project…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Patient Accounts Manager (Billing Project Management ) Patient Financial Services- Corporate- Full-Time Days** The Patient Accounts Manager ... oversees various aspects of accounts receivables management on a high level and ensures all outstanding...departments as necessary. + Monitors, implements and tracks all Medicaid applications. + Monitors the reconciliation of all manual… more
    Mount Sinai Health System (05/04/25)
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  • Registered Nurse, Community Based Care…

    Hackensack Meridian Health (Tinton Falls, NJ)
    …or other quality metrics and tracking. + Knowledgeable about Population Health Management and clinical integration principles and processes. + Good working ... serve as a leader of positive change. The **RN, Community Based Care Management ** provides direct support to physician practices and identifies complex patients or… more
    Hackensack Meridian Health (05/22/25)
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  • 340B Accountant; HSO Pharmacy; Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …+ Five years pharmacy reimbursement analysis and collection experience with Medicare, Medicaid , Pharmacy Benefit Manager and Commercial Health Plan payer ... Description** Provide analysis and demonstrate understanding of pharmacy revenue cycle management to optimize the payment cycle for retail and specialty pharmacy… more
    Mount Sinai Health System (04/08/25)
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  • Healthcare Payment & Financing Innovation Manager,…

    City of New York (New York, NY)
    …degree in public health , public policy, business administration, economics, health administration, health care management , marketing, or similar. ... Job Description The Center for Health Equity and Community Wellness (CHECW) seeks to...Claims Databases, and other employer-led strategies promote high-value care. Medicaid policy and strategy. Budget management experience… more
    City of New York (05/25/25)
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  • Medical Director, Behavioral Health

    Molina Healthcare (New York, NY)
    …Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and ... chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric… more
    Molina Healthcare (04/26/25)
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  • Deputy Commissioner, Office Of Audit…

    City of New York (New York, NY)
    …college in economics, finance, accounting, business or public administration, public health , human resources management , management science, operations ... (DHS). DSS-AO maintains the operation of the Office of Audit and Quality Assurance (OAQA), Office of Compliance and Support (OCS), Investigation, Revenue and… more
    City of New York (04/18/25)
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