• 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 (11/20/25)
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  • Medicaid Special Programs Case Manager

    CDPHP (Latham, NY)
    …and mail. The Medicaid Special Programs Case Manager typically works in the telephonic managed care setting but may be called on to work from a variety of ... clinical experience is required. + Previous experience working with Medicaid Long Term Care Programs preferred. +...patients with social needs preferred. + Experience in home care , medical office setting, or managed health… more
    CDPHP (11/21/25)
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  • Managed Care Coordinator

    Elderwood (Amherst, NY)
    …the HMO Managed Care Insurance Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review. Managed Care ... Salary Pay: $18.50 - $23.07 / Hour Overview Managed Care Coordinator Overview The ... liaison between the SNF and the HMO Managed Care Insurance Companies. This includes all… more
    Elderwood (11/24/25)
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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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  • Outpatient Care Manager

    Stony Brook University (Stony Brook, NY)
    …all potential medical interventions. + Demonstrates an understanding of managed care trends, payer regulations and Medicare/ Medicaid criteria for services. ... medical supplies and equipment. + Serves as an office liaison to outside nurses for patients on home telemonitoring....Experience in Care Management + Experience in Managed Care /Insurance Industry/MD Office. + Certified in… more
    Stony Brook University (11/20/25)
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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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  • Program Operations Specialist 1

    New York State Civil Service (Schenectady, NY)
    …answering questions as they pertain to other service reviews,- Reviewing Medicaid Compliance Liaison 's self-disclosures, quarterly activity summaries, and claim ... OPWDD is required by law to have an effective Medicaid Compliance Program in place. Proactive efforts and resources...Savings Plan.* Voluntary pre-tax savings programs such as Health Care Spending Account and the Dependent Care more
    New York State Civil Service (11/14/25)
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  • Care Coordinator-Psychiatry

    Mount Sinai Health System (New York, NY)
    …as needed + Ensures that patients have appropriate authorizations from various managed care insurers + Works as a liaison between MSHS and other community ... **Job Description** The Care Coordinator is responsible for coordinating care...Medicaid data to educate patients and form a care plan with specific health outcomes. The position is… more
    Mount Sinai Health System (11/25/25)
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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

    Molina Healthcare (Albany, 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 (10/17/25)
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  • Project Coordinator

    New York State Civil Service (Albany, NY)
    …of progressively responsible experience in Medicaid policy, program implementation, or managed care operations; OR a bachelor's degree and five (5) years ... impact new programs and changes may have on the Medicaid Long Term Care consumers and their...models and reimbursement rate methodologies for CDPAS providers and managed care plans; Prepare briefing materials-PowerPoints, policy… more
    New York State Civil Service (11/19/25)
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  • Registered Nurse 2 (Community)

    New York State Civil Service (Corinth, NY)
    …patient's plan of care meets their needs and acting as a liaison staff, providers, families or others involved in a patient's treatment to facilitate ... relevant duties as assigned. * Will act as a liaison to the Dental, Psychiatry and Primary care...for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility.*… more
    New York State Civil Service (11/14/25)
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  • Case Manager, RN (Medicare - Multiple Openings!)

    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
    Excellus BlueCross BlueShield (11/26/25)
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  • Case Manager - Registered Dietician

    CDPHP (Latham, 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
    CDPHP (11/25/25)
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  • Registered Nurse 1

    New York State Civil Service (Corinth, NY)
    …patient's plan of care meets their needs and acting as a liaison staff, providers, families or others involved in a patient's treatment to facilitate ... Disabilities, Office for Title Registered Nurse 1 Occupational Category Health Care , Human/Social Services Salary Grade 18 Bargaining Unit PS&T - Professional,… more
    New York State Civil Service (11/14/25)
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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 (11/27/25)
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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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  • Administrative Assistant 1/Trainee

    New York State Civil Service (West Seneca, NY)
    …and follow up on projects; and coordinate information flow by acting as liaison among executives, staff, other employees and the public.* Answers telephone and gives ... or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any...Savings Plan.* Voluntary pre-tax savings programs such as Health Care Spending Account and the Dependent Care more
    New York State Civil Service (11/21/25)
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  • Administrator of Admissions, Outreach & Intake

    Calvary Hospital (Bronx, NY)
    …by Calvary Hospital. Works cooperatively with other departments, provider referrers and managed care organizations to facilitate the admission of patients to ... the various programs provided by Calvary Hospital. Interfaces with managed care organizations to facilitate reimbursement for services provided by the Hospital.… more
    Calvary Hospital (11/19/25)
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