- Molina Healthcare (Syracuse, NY)
- …supporting compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Compliance Analyst position is primarily responsible for Medicare Oversight. + ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It… more
- Trinity Health (Syracuse, NY)
- …position Monday - Friday, Day Shift Schedule **Position: Clinical Risk Management Analyst ** **Mission Statement:** We, St Joseph's Health and Trinity Health, serve ... healing presence within our communities. **POSITION SUMMARY** The Clinical Risk Management Analyst is responsible for the overall patient safety and clinical risk… more
- Molina Healthcare (Syracuse, NY)
- **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and ... existing lines of business and expansion into new states. The Lead Analyst , Reimbursement will be primarily responsible for implementation, maintenance, and support… more
- Molina Healthcare (Syracuse, NY)
- **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting ... requirements into overall functional architecture for complex s/w solutions in compliance with industry regulations. *Provides subject matter expertise and reviews… more
- Molina Healthcare (Syracuse, NY)
- …internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures ... external auditors for all formal Core Operations audits that are not compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research,… more
- Molina Healthcare (Syracuse, NY)
- …+ Engages with operations leadership and Plan Support functions to review compliance -based issues for benefit planning purposes. **Recoveries & Disputes** + Review ... + Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). +… more
- SUNY Upstate Medical University (Syracuse, NY)
- …and commercial insurance rules and regulations is required, including regulatory compliance requirements. Extensive knowledge of Medicare , Medicaid, Managed Care ... of applicable Federal, State, and local laws and regulations. Monitors billing compliance with all third-party payer regulations. + Maintains confidentiality in … more