- MVP Health Care (Schenectady, NY)
- Case Manager , Medicaid Long Term Support Program 625 State St, Schenectady, NY 12305, USA * Rochester, NY, USA * Tarrytown, NY, USA Req #2653 Thursday, ... innovative thinking and continuous improvement. To achieve this, we're looking for a ** Case Manager , Medicaid Long Term Support Program** to join… more
- Elevance Health (Buffalo, NY)
- RN Utilization Management - Case Management ( Medicaid Long Term Care) JR155671 **Location** : New York or New Jersey. **Virtual:** This role enables ... thinking skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate equipment,… more
- Deloitte (Tempe, AZ)
- …health plan/insurance company experience + 5+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development + ... now or at any time in the future Preferred: + Experience providing Medicaid consulting services to Government agencies + Experience with Medicaid waivers… more
- City of New York (New York, NY)
- …TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to medically fragile and ... of initial applications, change actions, and renewals for all Medicaid funded long term care programs. This...and Federal guidelines and procedures. - Complete the required case action utilizing the Welfare Management System (WMS) and… more
- New York State Civil Service (New York, NY)
- …detectives, data analysts, and legal support analysts to conduct complex, long -term healthcare fraud investigations. The Medicaid program provides health ... HELP No Agency Attorney General, Office of the Title Legal Nurse/Medical Analyst: Medicaid Fraud Control Unit (6388) Occupational Category Legal Salary Grade NS… more
- New York State Civil Service (Albany, NY)
- …No Agency Attorney General, Office of the Title Legal Nurse/Medical Analyst: Medicaid Fraud Control Unit (6393) Occupational Category Legal Salary Grade NS ... State NY Zip Code 12224 Duties Description Criminal Justice Division Medicaid Fraud Control Unit - AlbanyMedical AnalystReference No. MFCU_ALB_ MA_6393Application… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500169 Medicaid Enrollment Work Shift: UR - Day (United States of America) Range: UR ... and provides outreach services to patients requiring public benefits including Medicaid , Child Health Plus, NYS Marketplace Exchange or other public entitlements.… more
- University of Rochester (Rochester, NY)
- …Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500169 Financial Case Management Work Shift: UR - Day (United States of America) Range: UR ... and provides outreach services to patients requiring public benefits including; Medicaid , Child Health Plus, NYS Marketplace Exchange or other public entitlements.… more
- Elevance Health (Walnut Creek, CA)
- …live in California. The **Medical Director** will be responsible for utilization review case management for Medicare and Medicaid in the California market while ... **Medical Director- Medicare and Medicaid ** Location: This role enables associates to work...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Elevance Health (Morgantown, WV)
- RN Utilization Management/Review Nurse - InPatient Medicaid (JR155056) **Location:** This position requires you to **reside in the state of West Virginia.** ... Hours** : Monday through Friday, 8am - 5pm The **Medical Management Nurse** ( Medicaid Utilization Review) is responsible for review of the most complex or… more
- Elevance Health (Topeka, KS)
- **LTSS Medical Director - Kansas Medicaid ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- Highmark Health (Dover, DE)
- …+ One year in home clinical or case management experience + Certified Case Manager (CCM) + Licensed Bachelors Social Worker (LBSW) + Licensed Masters Social ... care across the continuum of services and assisting members physical, behavioral, long term services and supports (LTSS), social, and psychosocial needs in the… more
- NorthWest Senior & Disability Services (Salem, OR)
- …Services + Develop transition plan + Implement, monitor and adjust transition plan + Transition case to ongoing Case Manager + Support and promote Diversion ... Disability Resources Connection (ADRC) concept + Facilitate confidence in Diversion and Transition Case Manager , and therefore the Agency and programs + Protect… more
- CVS Health (Union, NJ)
- …Certification or $7,500 for all other eligible external candidates._** **This is a remote Case Manager opportunity with** **50 to 75% field travel in Union ... writing and communication skills are required. **Fundamental Components/Job Description:** The Case Manager is responsible for conducting face to face… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for ... Medicaid & Medicare Services (CMS), Federal Employee Program (FEP)...Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …for you, we encourage you to apply! Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department ... of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP)...Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members… more
- BayCare Health System (New Port Richey, FL)
- …and clinical excellence. BayCare Health Systems is currently seeking an experienced ** Case Manager ** to join our outstanding and compassionate team in ... **Weekend Work** : No + **On Call:** Yes **The Case Manager is responsible for:** + ...Preferred for all case managers. + **Targeted Case Managers required to bill Medicaid .** **Benefits:**… more
- CVS Health (Hackensack, NJ)
- …for eligible external candidates who possess NJ Choice Certification_** **This is a remote Case Manager opportunity with** **50 to 75% field travel in Bergen ... writing and communication skills are required. **Fundamental Components/Job Description:** The Case Manager is responsible for conducting face to face… more
- CVS Health (Union, NJ)
- …Certification or $7,500 for all other eligible external candidates._** **This is a remote Case Manager opportunity with** **50 to 75% field travel in Union ... writing and communication skills are required. **Fundamental Components/Job Description:** The Case Manager is responsible for conducting face to face… more