- 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
- CDPHP (Latham, NY)
- …values and invites you to be a part of that experience. Conducts case management program activities in accordance with departmental, corporate, NYS Department ... of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee ...programs and applications. + Work collaboratively with all Case Managers, especially those with varied clinical expertise (ex.… more
- CVS Health (Albany, NY)
- …and more compassionate. And we do it all with heart, each and every day. ** Program Summary:** Join our Aetna care management team as we lead the way in providing ... will have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in...(DSNP) members, who are enrolled in both Medicare and Medicaid . As a member of the care team, you… 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
- CVS Health (Albany, NY)
- …and every day. **Job Purpose and Summary** As an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a ... of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring… 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
- CVS Health (Albany, NY)
- …and more compassionate. And we do it all with heart, each and every day. ** Program Overview** Join our Aetna team as we lead the way in providing exceptional care ... will have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in...(DSNP) members, who are enrolled in both Medicare and Medicaid and face a variety of complex health and… 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
- 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
- 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