- Highmark Health (Albany, NY)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Albany, NY)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Staffing Solutions Organization (Albany, NY)
- …Program needs and Policy changes to ensure reporting requirements, performance goals and Medicaid compliance . e. Lead the collaboration required to develop and ... of our clients and the people they serve. **Product Manager - Hybrid - Albany, NY** In this role,...internal and external customers, data engineers, analysts, developers, and Medicaid Program stakeholders to ensure the creation of high… more
- Humana (Albany, NY)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Pearson (Albany, NY)
- …path through this shifting environment to achieve continued success.** _Purpose Summary_ _The Medicaid and Vendor Implementation Manager will act as the main ... Pearson Virtual Schools' Connections Academy programs. Responsibilities include ensuring compliance with federal and state Medicaid regulations, optimizing… more
- Molina Healthcare (Albany, NY)
- …contractual requirements related to government programs including, but not limited to, Medicaid , duals (MMP) and Marketplace. * Serves as primary internal contact ... interpretations. * Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business… more
- Equinox, Inc (Albany, NY)
- Case Manager - Adult Residential Services Albany, NY (http://maps.google.com/maps?q=Albany+NY+USA) Job Type Full-time Description Equinox is a non-profit human ... and an addiction that need 24/7 support. Position Summary: The Residential Case Manager is responsible for providing service plan development and case management to… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Manager Performance Excellence and Accreditation - FT Days at St Peters Hospital** **POSITION ... **Provides leadership and expertise in the areas of accreditation and regulatory compliance , quality and patient safety standards as it relates to associates, staff,… more
- Saratoga Hospital (Saratoga Springs, NY)
- …a standardized organizational dyad structure with the Policy and Regulatory Readiness Manager to ensure regulatory compliance . The Clinical Regulatory Readiness ... but not limited to the Centers for Medicare and Medicaid (CMS) and the Joint Commission (JC), DNV, OSHA,...audits of NYS Medical Staff Licensure and DEA registration compliance . The clinical Regulatory Readiness Manager will… more
- Living Resources (Albany, NY)
- Community Living Case Manager (QIDP)/Intake Coordinator Albany, NY (http://maps.google.com/maps?q=Albany+NY+USA+12203) Job Type Full-time Description Living ... as needed, and maintain familiarity with both internal and external requirements for compliance . + Participate in agency and program training as it relates to tasks… more
- Humana (Albany, NY)
- …our caring community and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. ... The Senior Data Manager work assignments involve moderately complex to complex issues...Migration -- Planning and executing data migration projects. + Compliance -- Ensuring compliance with data protection… more
- LIFEPlan CCO NY (Clifton Park, NY)
- Care Manager Job Details Level Experienced Job Location Clifton Park - Clifton Park, NY Position Type Full Time Education Level 4 Year Degree Salary Range $25.00 - ... $27.00 Hourly Travel Percentage Up to 50% Job Summary: The Care Manager provides services within the Care Management programs, including Health Home Care… more
- Highmark Health (Latham, NY)
- …software packages such as Microsoft PowerPoint, Excel, Word. + Knowledge of required compliance with Centers of Medicaid and Medicare services (CMS) laws and ... regulations, policies and guidelines regarding Medicare Advantage and Medicaid plans; HIPAA privacy and security regulations. **EDUCATION** **Required** + Bachelor's… more
- Ellis Medicine (Schenectady, NY)
- SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management of assigned patients on a designated unit(s). This position works with the ... efficient quality care and achievement of desired treatment outcomes. The Case Manager confirms admission and continued stay are medically necessary and ensures the… more
- Equinox, Inc (Albany, NY)
- …including: selection, training and supervision of staff; selection of residents; compliance with OMH certification requirements and Medicaid documentation ... Program Manager - Adult Residential Services Albany, NY (http://maps.google.com/maps?q=Albany+NY+USA+12206) Job Type Full-time Description Equinox is a non-profit… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Health, Department of Title Community Health Program Manager 2 (NY HELPS) - 95003 Occupational Category Administrative or General Management ... City Albany State NY Zip Code 12237 Duties Description The Community Health Program Manager 2 (CHPM2) serves as Assistant Director of the Bureau of Tobacco Control… more
- Datavant (Albany, NY)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- Molina Healthcare (Albany, NY)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Negotiates agreements ... Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts including but not… more
- Molina Healthcare (Albany, NY)
- …needs, support to other business units + Strong business knowledge related to Medicaid and Medicare lines of business + Reviews enrollment issue trends and provides ... + Ensures compliant with regulatory and company guidelines, including HIPAA compliance + This position primarily focuses on project/program management related to… more
- Humana (Albany, NY)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more