• MetroPlusHealth (New York, NY)
    …a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care , Medicare, Child Health Plus, Exchange, Partnership in ... of Behavioral Health (Serious Mental Illness & Substance Use Disorder) experience in a managed care and or in a Psychiatric Hospital Inpatient and/or Outpatient… more
    Talent (10/07/25)
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  • MetroPlusHealth (New York, NY)
    …a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care , Medicare, Child Health Plus, Exchange, Partnership in ... Health (Serious Mental Illness & Substance Use Disorder) experience in managed care utilization review, quality assurance, discharge planning. (Experience… more
    Talent (10/10/25)
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  • Medicaid Managed Care

    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
    Abbott House (10/03/25)
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  • Therapy Managed Care Coordinator

    Elderwood (Buffalo, NY)
    …the HMO Managed Care Insurance Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review. EOE Statement WE ARE AN ... Salary $20 - $22 / Hour Overview Therapy Managed Care Coordinator Be the vital... liaison between our skilled nursing facilities and managed care organizations. Your work ensures patients… more
    Elderwood (10/01/25)
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  • Managed Care Coordinator

    Elderwood (Waverly, NY)
    …the HMO Managed Care Insurance Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review. Managed Care ... Salary $ 20 / $ 22 Overview Managed Care Coordinator Overview Mon-Fri 8am-4pm... liaison between the SNF and the HMO Managed Care Insurance Companies. This includes all… more
    Elderwood (10/07/25)
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  • Lead Analyst, Healthcare Analytics- Managed

    Molina Healthcare (Albany, 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 (09/11/25)
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  • Program Manager (Health Plan Liaison team)

    Molina Healthcare (Rochester, 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
    Molina Healthcare (10/11/25)
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  • Behavioral Health Advisor

    Staffing Solutions Organization (Albany, NY)
    …preferred candidate should have experience and an understanding of Medicaid and Medicaid services, including Managed Care and billing practices **Basic ... and policy implementation. **Primary responsibilities include:** + Assisting Bureau Director, Medicaid Program Manager, and Integrated Care Team in designing,… more
    Staffing Solutions Organization (07/16/25)
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  • Registered Nurse

    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 (09/27/25)
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  • Casa Director

    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
    City of New York (09/16/25)
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  • Growth & Community Engagement Specialist (Must…

    Molina Healthcare (Queens, 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 (10/07/25)
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  • Medical Director (AZ)

    Molina Healthcare (Syracuse, 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
    Molina Healthcare (09/26/25)
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  • Case Manager, RN or Licensed Behavioral Health…

    Excellus BlueCross BlueShield (Dewitt, NY)
    …Must demonstrate proficiency with the Microsoft Office Suite. + Experience in interpreting managed care benefit plans and strong knowledge of government program ... departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP)...staff to identify opportunities to successfully engage members into care . + Acting as a liaison for… more
    Excellus BlueCross BlueShield (10/11/25)
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  • Habilitation Specialist 1 - Quality Management…

    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
    New York State Civil Service (10/08/25)
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  • Credit&Coll Ana-Hospital

    WMCHealth (Valhalla, NY)
    …general experience up to a maximum of two years. (2)Experience which involved direct liaison with managed care agencies, that included processing referrals, ... Blue Cross/Blue Shield, Workers' Compensation, private insurance carriers, Medicare and Medicaid to verify the patient's eligibility for coverage, the portion of… more
    WMCHealth (09/12/25)
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  • Pharmacist, Utilization Management (UM)

    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
    Molina Healthcare (10/09/25)
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  • Specialty Sales Representative, Immunology

    Grifols Shared Services North America, Inc (Albany, NY)
    …contract strategy, and represent needs of the customer. *Remain cognizant of managed care coverage throughout the business territory including major accounts ... approach to respond to business customers. The SSR will liaise with Marketing, Managed Markets, Operations, CL&D, Medical Affairs and Telesales to achieve the goals… more
    Grifols Shared Services North America, Inc (10/12/25)
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  • RN - MDS Coordinator

    Elderwood (Cheektowaga, NY)
    …Payment Model (PDPM) and Case Mix Index (CMI) preferred + Experience with state Medicaid program, Medicare/PPS program, Managed Care programs, RUGs III and ... RUGs categories for each individual assessment. + Acts as support/ liaison to the business office coordinator and/or designee in...in the facility. + Serves as facility contact with Managed Care providers to ensure appropriate authorization… more
    Elderwood (10/04/25)
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  • Clinical Operations Leader

    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
    Help at Home (09/03/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …, end-of-life- care and hospice. + Apply knowledge of Health Insurance and Managed Care Programs, along with values- based care , pay-for-performance ... PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level of … more
    Mohawk Valley Health System (10/07/25)
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