- 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
- 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 (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)
- …Coordination Organizations, Consumer Advisory Board (CAB) advocates, and interface with the Medicaid Compliance Liaison . * Create tickler system to maintain ... Specialist 1 - Quality Management - EOA #2025-219 Occupational Category Health Care , Human/Social Services Salary Grade 14 Bargaining Unit PS&T - Professional,… more
- Sanofi Group (Morristown, NJ)
- …resolve reimbursement issues for Sanofi Vaccines portfolio in the Commercial and Managed Medicaid space. Sanofi's global vaccines business unit partners with ... **Location:** Remote/Field **About the Job** The Director, Reimbursement Education Liaison role will engage different/relative stakeholders within the ecosystem of… more
- Molina Healthcare (Yonkers, NY)
- …and applicable software program(s) proficiency. **Preferred Qualifications** * Medicare Part D and/or Medicaid experience. * Managed care experience. To all ... care . **Essential Job Duties** * Acts as a liaison between Molina and its customers (members, providers and...experience in a pharmacy, Pharmacy Benefit Manager(PBM), formulary, and/or managed care setting, and 1-2 years post-graduate… more
- New York State Civil Service (Staten Island, NY)
- …entries and provide reports to support internal controls* Will serve as liaison between residential managers, residential team leaders and leadership in regard to ... staff utilization* Principal liaison with ERO and HR re: OIL, Administrative Leave,...Dietitian 2, Habilitation Specialist 2, Infection Control Nurse, Intermediate Care Facility Program Manager 1, Intermediate Care … 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 ... higher 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
- 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 (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