- 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
- 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)
- …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
- WMCHealth (Valhalla, NY)
- …general experience up to a maximum of two years. (2)Experience which involved direct liaison with managed care agencies, that included processing referrals, ... Blue Cross/Blue Shield, Workers' Compensation, private insurance carriers, Medicare and Medicaid to verify the patient's eligibility for coverage, the portion 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
- Help at Home (Brooklyn, NY)
- …ensures compliance with New York State Department of Health (DOH) regulations, Managed Long-Term Care (MLTC) program requirements, and Federal guidelines. The ... Home is the leading national provider of in-home personal care services, where our mission is to enable individuals...+ Ensure compliance with DOH regulations, MLTC guidelines, and Medicaid contractual obligations. + Oversee all aspects of client… 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
- New York State Civil Service (Queens Village, NY)
- …health care needs. * Maintains ongoing communication with med liaison /designee. * Provides support to residential staff in maintaining health services for ... Disabilities, Office for Title Registered Nurse 1 Occupational Category Health Care , Human/Social Services Salary Grade 18 Bargaining Unit PS&T - Professional,… 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