- 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
- Lutheran (West Seneca, NY)
- … services to youth as appropriate, as required by 29-I regulations + Coordinates with the Medicaid Managed Care Liaison (MMCL) and RN Supervisor for all ... medical and discharge planning services for our therapeutic foster care youth. Qualifications: Applicant must have graduated from an...Manages the medical case file for all assigned foster care youth + Be available to staff for consultation… more
- City of New York (New York, NY)
- … with other agencies such as the NY State Department of Health (SDOH), NY Medicaid CHOICE/MAXIMUS, Managed Care Organizations (MCOs), the Office of ... the Executive Director, of the Office of Mail Renewal, Managed Care Program (MCP), and Third-Party Health...Organizations (MCOs) and case management providers through which eligible Medicaid clients access behavioral and health care … more
- City of New York (New York, NY)
- …APPLICANTS MUST BE PERMANENT IN THE PRINCIPLE ADMINISTRATIVE ASSOCIATE CS TITLE The Home Care Services Program (HCSP) is a Medicaid funded program that provides ... daily living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the...and guidelines. - Participate in meetings and act as liaison with MAP staff involved in developing Medicaid… more
- Elderwood (Cheektowaga, NY)
- …the HMO Managed Care Insurance Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review. Managed Care ... Overview Managed Care Coordinator Overview The ...Overview Managed Care Coordinator Overview The Managed ... liaison between the SNF and the HMO Managed Care Insurance Companies. This includes all… more
- Cardinal Health (Albany, NY)
- …in the healthcare management industry including Prior Authorizations, Appeals, Medicare Part D, Medicaid , Managed Care , and Commercial plans is preferred. + ... (TM) Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy… 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
- 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
- Whitney Young Health Center (Albany, NY)
- …to ensure productivity standards for care coordination programs; . Interfaces with Managed Care Organizations (MCO) Complex Care Managers as to ensure ... Provides administrative oversight and supervision for program managers . Serves as liaison and fosters collaborative relationships between primary care providers… more
- City of New York (New York, NY)
- …medication and other health care services at little or no cost. MAP Managed Care Client Services (MCCS) - Restricted Recipient Program (RRP) Unit imposes ... within MAP to ensure appropriate delivery of services to clients enrolled in managed care . - Type correspondences, reports and other written materials. -… more
- Molina Healthcare (Spencerport, 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 (Syracuse, NY)
- …and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PR** **E** **FE** **R** **RED L** ... **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and… more
- Excellus BlueCross BlueShield (Rochester, 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
- City of New York (New York, NY)
- …commercial payors at the federal and state levels, and the evolution of managed care . The regulation and financing of community-based organizations (CBO's) at ... transparency, All-Payer Claims Databases, and other employer-led strategies promote high-value care . Medicaid policy and strategy. Budget management experience… more
- 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
- Elderwood (Waverly, 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
- Molina Healthcare (Buffalo, NY)
- …equivalent experience. **Required Experience** At least 7 - 10 years of experience in Managed Care and/or health plan quality. Clinical experience is needed for ... matter expert in all functional areas in, quality improvement (primarily Medicaid ) and data capture/supplemental data submission and coordinating national and local… more
- Molina Healthcare (Rochester, NY)
- …in a managed care of PBM environment + 2+ years of Managed Medicaid or Health Exchanges. + 2+ years of operational Marketplace experience **Preferred ... attention to detail, analysis and excellent communication. **KNOWLEDGE/SKILLS/ABILITIES** + Support Medicaid , and Marketplace lines of business with an emphasis on… more
- City of New York (New York, NY)
- …of public and commercial payors at the federal and state levels, and the evolution of managed care - Value-based care and Alternative Payment Models. - Price ... the most impacted NYC communities. CHECW addresses inequity across community and health care systems in partnership with community, faith-based, and health care … more
- New York State Civil Service (West Seneca, NY)
- …Review and process referrals for AT, E-Mod, V-Mod Services.* Act as liaison between Care Coordination Oganizations, provider agencies and individuals/families as ... Social Work Assistant 2 (NY HELPS) EOA #25-386jh Occupational Category Health Care , Human/Social Services Salary Grade 17 Bargaining Unit PS&T - Professional,… more