- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. ** Medicaid Program Advisor 1 in Albany, NY** **Strategic Operations and Planning ... other MS Office applications, and an understanding of governmental operations and the Medicaid program would be preferred. **Basic Qualifications:** + 8 years of… more
- CDPHP (Latham, NY)
- …requests for prior authorization received via the telephone line, fax machine and mail. The Medicaid Special Programs Case Manager typically works in the ... invites you to be a part of that experience. The Medicaid Special Programs Registered Nurse Case Manager is responsible and accountable for coordinating… more
- MVP Health Care (Schenectady, NY)
- …and continuous improvement. To achieve this, we're looking for a ** Case Manager, Medicaid Long Term Support Program ** to join #TeamMVP. If you have a passion ... years of recent clinical and Case Management experience. Experience working in a Medicaid Long Term Support Program (LTSS) or Health Home required. + Must… more
- CVS Health (Albany, NY)
- …years of leadership experience + A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare ... comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred. Leads a team in the...to take in a timely and effective manner. Conducts case reviews and provides feedback to investigators on completeness… more
- Cardinal Health (Albany, NY)
- …life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient support ... services in accordance with the program business rules and HIPAA regulations. This role involves...and short-range changes in the reimbursement environment including Medicare, Medicaid , Managed Care, and Commercial medical and pharmacy plans… more
- CVS Health (Albany, NY)
- …day. **Job Summary:** The Care Manager-Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who ... of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring… more
- Saratoga Hospital (Saratoga Springs, NY)
- …nursing background (RN) preferred. Knowledge regarding health insurance health insurance programs and/or facilitated enrollment (ie Medicaid ) a plus. Basic ... Case Management Representative Salary Range: $37-$57 About Saratoga...required. Solid working knowledge of Microsoft Office is required. Special Equipment, Skills or Other Requirements: Must be self-directed… more
- Molina Healthcare (Albany, NY)
- …procedures with emphasis on fraud investigations. + Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace. + Understanding of ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation,… more
- Molina Healthcare (Albany, NY)
- …health coverage audit policies and be able to apply them in ensuring program compliance via payment integrity programs . The position must have the ... will ensure the Manager is aware of any major case developments, and ensure cases are being investigated according...fraud investigations + Knowledge of Managed Care and the Medicaid and Medicare programs as well as… more
- St. Catherine's Center for Children (Albany, NY)
- SUPERVISOR, OCCUPATIONAL THERAPY SERVICES Program : Special Education/Day Treatment (R&E May School) Type : Part-time; Non-Exempt Pay Range : $30.00 - $40.00 ... families and adults, including residential and therapeutic foster care programs for children and youth, Kinship support, homeless and...daily notes completed by the COTA + Complete quarterly Medicaid notes on case load and sign… more
- Humana (Albany, NY)
- …and independence, while using a multidisciplinary team. This position will be part of our Special Needs Program (SNP) team. All of our SNP RN Care Managers are ... EST.** Our nurses are titled Care Managers, because our case management services are centered on the person rather...This is a very compliance driven and highly visible program at Humana. The nature of the work requires… more
- New York State Civil Service (Schenectady, NY)
- …eligibility for full and unconditional participation in the Medicare and Medicaid programs . Continued employment will depend on maintaining eligibility.* ... with interdisciplinary team members to promote optimal health outcomes. The Nursing Case Manager also serves as a liaison between medical providers, clinic staff,… more
- New York State Civil Service (Corinth, NY)
- …eligibility for full and unconditional participation in the Medicare and Medicaid programs . Continued employment will depend on maintaining eligibility.* ... with interdisciplinary team members to promote optimal health outcomes. The Nursing Case Manager also serves as a liaison between medical providers, clinic staff,… more
- Capital Region BOCES (Albany, NY)
- LOCATION: Special Education & Career & Technical Education Buildings BASIC FUNCTION: Employees in this class have immediate responsibility for the direction and ... supervision of school nursing personnel within all BOCES programs engaged in a variety of school nursing activities....the school administrator in planning the overall school nursing program . Employees confer with the school administrator in the… more
- New York State Civil Service (Albany, NY)
- … administered by OTDA and other Executive agencies (eg, the Department of Health's Medicaid program , the Office of Children and Family Services' foster care and ... childcare programs , and the Office for People with Developmental Disabilities...denial, discontinuance, reduction, and/or adequacy of social services benefit program determinations. They may also preside over hearings addressing… more
- Schenectady City School District (Schenectady, NY)
- …in performance of their duties. Activities may include Individualized Education Program (IEP) development, Medicaid billing, report writing, and treatment ... selected through an evidence-based decision-making process; + Engage in designing schoolwide programs that employ a continuum of service delivery models in the least… more
- St. Catherine's Center for Children (Albany, NY)
- CARE MANAGER Location: Albany, NY Program : Community Outreach & Care Coordination Type: Full-time / Non-Exempt Pay Range: $22.06 - $25.18 (hourly) Schedule: Monday - ... throughout the region. Position Overview Following the Children's Health Homes Care Management program guidelines as set forth by the NYS Department of Health, the… more
- Molina Healthcare (Albany, NY)
- …* Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, case management referrals, over ... Committee of Quality Assurance (NCQA) guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy… more
