- CDPHP (Albany, NY)
- …requests for prior authorization received via the telephone line, fax machine and mail. The Medicaid Special Programs Case Manager typically works in the ... invites you to be a part of that experience. The Medicaid Special Programs Registered Nurse Case Manager is responsible and accountable for coordinating… more
- New York State Civil Service (Albany, NY)
- …civil and criminal evidentiary hearings and trials in New York state courts.The Medicaid program provides health coverage to millions of New Yorkers, including ... with ensuring the financial integrity of New York state's $94 billion Medicaid program by investigating healthcare providers, such as pharmaceutical companies,… more
- CVS Health (Albany, NY)
- …candidates may be eligible for up to a $7,500 sign on bonus upon hire.** ** Program Overview** Help us elevate our patient care to a whole new level! Join our ... on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex...are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical… more
- Public Consulting Group (Albany, NY)
- …needed + Understand the important points of intersection and overlap between our Special Education/ Case Management and school-based Medicaid services work ... strategic clients + Understand and continually monitor Federal, state, and local Medicaid School-Based program policies and guidance, collaborating with PCG… more
- St. Catherine's Center for Children (Albany, NY)
- …("QA Specialist") is responsible for various aspects of the Quality Assurance Program under the direction of the Deputy Executive Director ("Chief Compliance ... (CQI). This includes but is not limited to completing case record reviews to ensure documentation and services are...in related field may be considered. + Knowledge of Medicaid regulations; New York Foster Care system (specific to… more
- Humana (Albany, NY)
- …and independence, while using a multidisciplinary team. **This position will be part of our Special Needs Program (SNP) team** . All of our SNP RN Care Managers ... EST.** Our nurses are titled Care Managers, because our case management services are centered on the person rather...This is a very compliance driven and highly visible program at Humana. The nature of the work requires… more
- New York State Civil Service (Albany, NY)
- … administered by OTDA and other Executive agencies (eg, the Department of Health's Medicaid program , the Office of Children and Family Services' foster care and ... childcare programs , and the Office for People with Developmental Disabilities...denial, discontinuance, reduction, and/or adequacy of social services benefit program determinations. They may also preside over hearings addressing… more
- Whitney Young Health Center (Albany, NY)
- … Medicaid services; Medical terminology and abbreviations; Medicare and Medicaid programs including medical documentation, covered services, billing ... and accuracy in billing and medical documentation for private and government programs ; identifies areas that would permit enhanced reimbursement and reduce denials… more
- Schenectady City School District (Schenectady, NY)
- …in performance of their duties. Activities may include Individualized Education Program (IEP) development, Medicaid billing, report writing, and treatment ... selected through an evidence-based decision-making process; + Engage in designing schoolwide programs that employ a continuum of service delivery models in the least… more
- CVS Health (Albany, NY)
- …Appeals / Second Level Appeals / Expedited Appeals / Appeal Hearings / Special Projects and Committee participation when needed. The Medical Director will provide ... clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a business and clinical liaison… more
- St. Catherine's Center for Children (Albany, NY)
- …children, families and adults, including residential and therapeutic foster care programs for children and youth, Kinship support, homeless and community-based ... services for adults and families, a special education elementary school for ages 5-13, and so...Position Overview: Following the Children's Health Homes Care Management program guidelines as set forth by the NYS Department… more
- Trinity Health (Albany, NY)
- …will have 3-5 years in risk management / patient safety experience. ** SPECIAL EQUIPMENT, SKILLS OR OTHER REQUIREMENTS:** Strong written and oral communication ... Supports the education components of the facility's risk management program . Promotes the organizational patient safety initiatives. **LOSS PREVENTION/PATIENT… more