- Centers Plan for Healthy Living (Staten Island, NY)
- Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #266 Monday, September 9, 2024 Centers Plan for Healthy Living's goal is to create the ... they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and...performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling… more
- Elevance Health (East Syracuse, NY)
- **Audit & Reimbursement III- Medicare Cost Report Appeals** **Location** : This is a virtual position; US based **National Government Services** is a proud member of ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Ellis Medicine (Schenectady, NY)
- SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management of assigned patients on a designated unit(s). This position works with ... compassionate, efficient quality care and achievement of desired treatment outcomes. The Case Manager confirms admission and continued stay are medically… more
- Lifespan (Rochester, NY)
- Financial Case Manager Rochester, NY (http://maps.google.com/maps?q=1900+South+Clinton+Ave+Rochester+NY+USA+14618) Description JOB TITLE:Financial Case ... plan and maintain long-term financial security of clients. The case manager is responsible for processing Social...but not limited to SSI and Medicaid, MMLTC, VA, Medicare , SNT. . Must have attention to detail and,… more
- BronxCare Health System (Bronx, NY)
- Overview The Case Manager will coordinate care using a collaborative approach with the multidisciplinary team in identifying the required services needed to meet ... and report problematic cases with extended LOS providing updated information to Utilization Case Manager and /or Director for further action. Identify quality… more
- Goddard Riverside (New York, NY)
- Case Manager (NORC) Job Details Job Location GRCC NORC - New York, NY Salary Range $43,000.00 - $52,000.00 Salary/year Description Organization Overview: The ... services provided by on-site Goddard Riverside staff. Purpose of Position: The NORC Case Manager provides individualized services to enable seniors to live… more
- Molina Healthcare (Bronx, NY)
- …Supports (** **LTSS) is highly preferred. Strong organizational and time management skills. The Case Manager must have the ability to work in a high-volume ... + **Bilingual** **Preferred License, Certification, Association** Active and unrestricted Certified Case Manager (CCM) To all current Molina employees: If… more
- CVS Health (Albany, NY)
- …network management, clinical coverage, and policies. **Position Summary/Mission** Community Care Case Manager use a collaborative process of assessment, ... CM, discharge planning and/or home health care coordination experience + Certified Case Manager is preferred. + Excellent analytical and problem-solving skills… more
- Molina Healthcare (Bronx, NY)
- …and Supports (LTSS) is highly preferred. Strong organizational and time management skills. The Case Manager must have the ability and be comfortable to working ... **Bilingual** **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Active and unrestricted Certified Case Manager (CCM) Active, unrestricted State Nursing license… more
- CAI (Albany, NY)
- …Type** Full time **Worksite Flexibility** Remote **Job Summary** We are looking for a motivated RN Case Manager ready to take us to the next level! If you have ... career move, apply now. **Job Description** We are looking for a RN Case Manager to provide community-based care coordination/management for our client's members… more
- CVS Health (Albany, NY)
- …it is preferred that RN license is part of the compact. + Certified Case Manager + Bilingual desired (English/Spanish or English/Russian) + Confidence working at ... on our **Dual Eligible Special Needs Plan** (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social… more
- Healthfirst (NY)
- …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which...Centers for Medicare & Medicaid Services (CMS) or New York State… more
- Northwell Health (Huntington, NY)
- …companies and physicians regarding utilization issues. + Utilizes important message from Medicare (IMM) when appropriate. + Ensures managed care reviews are up to ... management of patient care outcomes. + Submits data to management regarding case management and/or quality initiatives. + Participates in data collection regarding… more
- Cardinal Health (Albany, NY)
- …equivalent preferred * Patient Support Service experience, preferred * Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines ... for coverage, preferred * Knowledge of DME, MAC practices if preferred * Clear understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred * 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience * 1-2… more
- VNS Health (Manhattan, NY)
- …Nurse or an Occupational Therapist in New York State required + Certified Case Manager preferred + For SelectHealth ETE Only: Nurse Practitioner (NP) ... cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in… more
- VNS Health (Manhattan, NY)
- …Nurse or an Occupational Therapist in New York State required + Certified Case Manager preferred + For SelectHealth ETE Only: Nurse Practitioner (NP) ... cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in… more
- VNS Health (Manhattan, NY)
- …Professional Nurse or an Occupational Therapist in New York State required Certified Case Manager preferred For SelectHealth ETE Only: Nurse Practitioner (NP) ... cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in… more
- CVS Health (Albany, NY)
- …network management, clinical coverage, and policies. **Position Summary/Mission** Community Care Case Manager use a collaborative process of assessment, ... CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members. * Minimum 2+ years CM, discharge planning...company will provide. * Bachelor's degree preferred. * Certified Case Manager is preferred. * Additional national… more
- CVS Health (Albany, NY)
- …network management, clinical coverage, and policies. **Position Summary/Mission** Community Care Case Manager use a collaborative process of assessment, ... and healthcare personnel as appropriate. + Implements and coordinates all case management activities relating to catastrophic cases and chronically ill… more
- VNS Health (Manhattan, NY)
- …following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA) or Select Health. Ensures compliance with state and federal ... operational and regulatory compliance. Maintains and ensures integrity of case file and data collection systems and prepares data...Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Part D, or Select Health to… more