- 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
- Teva Pharmaceuticals (Parsippany, NJ)
- Associate Director, Managed Care Payer Contracting Date: Oct 17, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job ... generation of pharmaceutical access in a high-growth environment.** The Associate Director, Managed Care Payer Contracting plays a pivotal role in supporting… more
- Molina Healthcare (Yonkers, 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 (Yonkers, NY)
- …EXPERIENCE** : * 5-7 years of Program and/or Project management experience. * Managed Care experience. * Experience working in a cross functional highly ... Provide credentialing/recredentialing details for monthly/quarterly/semi-annual turnaround time reports to Medicaid agencies as required + Active collaborator with people… 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
- 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
- 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 (Yonkers, 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
- Molina Healthcare (Yonkers, 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
- New York State Civil Service (New York, NY)
- …Care Coordination Organizations, Consumer Advisory Board (CAB) advocates, and the Medicaid Compliance Liaison .* Tracking System Creation: Develop a tickler ... for Title Habilitation Specialist 1 - EOA #2025-246 Occupational Category Health Care , Human/Social Services Salary Grade 14 Bargaining Unit PS&T - Professional,… more
- Centene Corporation (Queens, NY)
- …claims processing or utilization and case management in a clinical practice or managed care organization. Experience analyzing various types of data and ... Medicaid Services (CMS regulations). Working in a home care environment or as a staff nurse in an...a staff nurse in an acute, sub-acute or long-term care (LTC) setting or managed long-term … more
- 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
- Mount Sinai Health System (New York, NY)
- …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or ... is preferred in analytics development expertise, preferably in health care , or for a health provider, health plan or...Soarian, etc. + Knowledge of the New York State Medicaid and CMS Medicare regulations and related reporting requirements,… more
- New York State Civil Service (Thiells, NY)
- …6 State Operated Development Disabilities Service Operation Offices, and 7 Care Coordination Service Organizations. Region Field Office oversight encompasses 13 ... OPWDD to provide necessary services to individuals with disabilities. As a Unit Liaison , the incumbent will perform administrative duties related to the operation of… more
- Mount Sinai Health System (New York, NY)
- …pharmacy group. 11.Obtains prior authorizations from intermediaries and payers, including managed care companies, insurance companies or others as appropriate. ... including Medicare , Medicaid and TriCare. Preferred: 3 years of health care related billing and benefits investigation 1 year of retail pharmacy experience 1… more
- Molina Healthcare (Yonkers, NY)
- …10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and… more
- Molina Healthcare (Yonkers, NY)
- …License for workplace and plan location. **Preferred Experience** + Medicare Part D or Medicaid experience. + Managed care experience. To all current Molina ... with questions regarding drug coverage. + Acts as a liaison between Molina and its customers (members, providers and...Case Management department as part of a member-centered interdisciplinary care team. + Works with the PBM to manage… more
- Centene Corporation (Queens, NY)
- …federal contracts, related laws, regulations and executive orders. + Deep understanding of managed care models (HMO, PPO, Medicaid , Medicare Advantage, ... + Familiarity with healthcare laws, reimbursement models, and value-based care initiatives. + Perform duties as senior liaison... care initiatives. + Perform duties as senior liaison between product line, other business units, corporate, and… more
- Centene Corporation (New York, NY)
- …years of provider reimbursement and analysis experience. Experience with Medicare and Medicaid reimbursement methodology. Managed care experience and ... align with industry standards and state requirements. Serve as the key liaison between health plan network management, finance and contract implementation and… more
- Elevance Health (New Hyde Park, NY)
- …an equivalent background. **Preferred Skills, Capabilities, and Experiences:** + Understanding of managed care or Medicaid /Medicare strongly preferred. + ... when requested. + May assist with complex cases. + May act as liaison between Medical Management and/or Operations and internal departments. + Maintains and updates… more