- City of New York (New York, NY)
- …is recruiting for one (1) Principal Administrative Associate II, to function as a Medicaid Consultant within the Central Intake Unit, who will: - Interpret ... TITLE. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to...Medicaid policies and procedures for assigned cases for individuals… more
- New York State Civil Service (New York, NY)
- …HELP No Agency Attorney General, Office of the Title Legal Nurse/Medical Analyst: Medicaid Fraud Control Unit (6388) Occupational Category Legal Salary Grade NS ... NY Zip Code 10005 Duties Description Criminal Justice Division Medicaid Fraud Control Unit - New York City Medical...managed care; * Prior experience as a legal nurse consultant ; and * Knowledge of state and federal rules… more
- CenterWell (Albany, NY)
- …financial data driven methods to develop and influence drug strategies for the Medicaid lines of business. + Utilizes broad understanding of pharmacy, managed care, ... PBM, market and regulatory insights to support the development of Medicaid formulary and medical drug strategies to mitigate Humana's costs and trend while improving… more
- NTT DATA North America (Albany, NY)
- …and forward-thinking organization, apply now. We are currently seeking a Senior Security Consultant to join our team in Albany, New York (US-NY), United States (US). ... The Senior Security Consultant will report to the Project Director for the...and oversight of security, privacy, and compliance for the Medicaid Transformation program. The mission of the program is… more
- Humana (Albany, NY)
- …as Dual Eligibles, Veterans, and other needs-based segments. The Medicare and Medicaid organization, Humana's largest, comprises over 80% of the company's total ... Consumer Segment's highest priority strategy projects and initiatives. As a Consultant , you will deconstruct issues and challenges, perform targeted research and… more
- City of New York (New York, NY)
- …with essential benefits such as Cash, Food and Rental Assistance as well as Medicaid . The Office of the Medical Director aims to improve the health and well-being ... one (1) City Medical Specialist (Per Diem) to function as a Medical Consultant who will: - Indirectly supervise contracted clinical staff, share policies and… more
- Cognizant (Albany, NY)
- **Healthcare Product Consulting - NetworX Consultant (Remote)** **Job Summary** : The NetworX Product Consultant is responsible for providing customers with ... configuration. + Knowledge of health plan operations for Medicare, Medicaid , Marketplace, LTSS, DSNP (duals) is highly preferred. **Preferred Qualifications:**… more
- CVS Health (Albany, NY)
- …Managed Care or Managed Long Term Care experience + Prior Authorizations + Medicaid and Medicare Processes **Education** + Minimum of a Bachelor's Degree in Nursing ... required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $32.01 - $68.55 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within… more
- Excellus BlueCross BlueShield (Liverpool, NY)
- …families. * Qualifies Medicare prospects onsite per Centers for Medicare & Medicaid Services (CMS) Regulations and closes sale wherever possible and as appropriate. ... Completes and submits enrollment forms for closed sales within the specified timeline. * Improves customer retention through on-boarding best practices defined as part of the assistor process. Acts as a member advocate for the individual to the Marketplace.… more
- The Arc Erie County NY (Williamsville, NY)
- …agency, the Office for People With Developmental Disabilities OPWDD, Medicaid , Medicare, insurance companies, municipalities, Department of Health, school districts, ... to further benefit the person for maximum carry over. + Serves as a consultant to staff and team members addressing questions relating to motor development and… more
- The Arc Erie County NY (Buffalo, NY)
- …agency, the Office for People With Developmental Disabilities OPWDD, Medicaid , Medicare, insurance companies, municipalities, Department of Health, school districts, ... further benefit the person for maximum carry over. + Serves as a consultant to staff and team members addressing questions relating to communication and… more
- ManpowerGroup (Albany, NY)
- …incorporate multi-system data feeds to bill a variety of payers including Medicaid , Medicare & Third-Party Health Insurance (TPHI) for services rendered. This ... the OMH State Operations Finance Group. * Support billing of Medicare, Medicaid , Third Party Health Insurance (TPHI), & individuals (private parties). Monitor batch… more
- Greece Central School District (North Greece, NY)
- …by a physician, physician's assistant, or nurse practitioner that are Medicaid compliant; Delivering evidence based treatment and interventions to students district ... wide (K-12+) in a variety settings; Acting as a consultant to provide strategies for classroom teachers; Completing documentation of all evaluations, reevaluations,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and divisional meetings, including in person meetings. + Serves as a resource and consultant to other areas of the company. + May be required to represent the ... the utilization management program policies and procedures. + Serves as a resource and consultant to other areas of the company. + Assists in many aspects of… more
- Humana (Albany, NY)
- …consumer experiences + Scaled Agile (SAFe) certification(s): RTE and/or Safe Program Consultant (SPC) + Scrum Master certification like CSP-SM, A-CSM, or PSM III ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- CenterWell (Albany, NY)
- …others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over. ... practice residency or similar pharmacy practice experience** **Knowledge of Medicare and Medicaid as it relates to pharmacy** **Six Sigma and/or Project Management… more
- CenterWell (Albany, NY)
- …others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over. ... practice residency or similar pharmacy practice experience** **Knowledge of Medicare and Medicaid as it relates to pharmacy** **Six Sigma and/or Project Management… more
- Bassett Healthcare (Herkimer, NY)
- …to remain current in the provision of social work services. Meets regularly with consultant . Maintain contact with other social workers in Long Term Care. Acts as ... and/or designated representative with financial concerns (Medicare, Social Security, Medicaid ). Provide residents and/or designated representatives with information and… more
- Trinity Health (Albany, NY)
- …system quality and safety committees and teams. + Serves as a resource/ consultant to all departments related to quality, safety, accreditation and regulatory issues. ... medical staff departments or services + Previous Joint Commission and Centers for Medicaid and Medicare accreditation experience preferred, with a minimum of 5 years… more
- Ellis Medicine (Schenectady, NY)
- …and coordinate transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or discharge planning needs + Coordinates ... York State Department of Health and Centers for Medicare and Medicaid Services discharge planning guidelines and departmental/organizational policies and processes +… more