- Molina Healthcare (New York, NY)
- …tools, and presents healthcare utilization and cost containment reports across Medicaid , LTSS, Medicare, and Marketplace, and makes recommendations based on relevant ... findings. **Knowledge/Skills/Abilities** Directs Health Plan strategic analysis and planning coordinating across business units to meet financial data analysis needs. * Mentors, coaches, and provides guidance regarding finance and analysis. * Identifies and… more
- Molina Healthcare (New York, NY)
- …and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare, Medicaid , Market Place products, laws, rules and regulations **Preferred Education** * Master's ... degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4, HCPCS coding **Preferred License, Certification, Association** Professional… more
- Alternatives, Inc. (Raritan, NJ)
- …illnesses. The Community Outreach Services Department is currently seeking a Director of Community Outreach Services. ESSENTIAL DUTIES AND RESPONSIBILITIES: - ... communication skills. - Familiarity or prior experience with Fee-For-Service Medicaid environments is a plus. - Experience working with...commute to the main office in Raritan NJ, and remote , using Go To Meeting. All trainings are compensated.… more
- Vibrant Emotional Health (New York, NY)
- Job Title: Program Director Department: Youth and Family Wellness Reports To: Assistant Program Director Schedule: Monday to Friday, 9am to 5pm Location: ... Remote /Hybrid Flexed, cases in Manhattan, Bronx, Queens Pay Grade:...and the budgeted amount for the role. Clinical Program Director Vibrant (formerly the Mental Health Association of New… more
- Elevance Health (Morristown, NJ)
- ** Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** Alternate locations may be considered. This position will work a hybrid model ( ... remote and office). The ideal candidate will live within...50 miles of our Elevance Health PulsePoint locations. The ** Director of Medicare Risk Adjustment Analytics and Reporting** is… more
- NYU Rory Meyers College of Nursing (New York, NY)
- Position Summary Reports to the Associate Dean of Clinical Administration. The Director of Dental Insurance Strategy is a visionary leader responsible for expanding ... as a leading provider of comprehensive dental care. Additionally, the Director will design and implement innovative self-pay payment strategies, providing patients… more
- Elevance Health (Woodbridge, NJ)
- …care. CarelonRx's Pharmaceutical Rebates Org is looking to hire a ** Director , Formulary Strategy Development.** This high-performing individual contributor will play ... role in driving affordability across multiple lines of business (Commercial, Medicaid , Medicare, ASO clients) by partnering with internal and external stakeholders… more
- Bristol Myers Squibb (Madison, NJ)
- …work and in their personal lives. Read more: careers.bms.com/working-with-us . **Summary:** The Director of US Access Strategy - CAR T is responsible for the ... payers, payer contracting, and health economics + Deep understanding of Medicare and Medicaid policies related to CAR T therapies + Expertise in Cell Therapy coding… more
- City of New York (New York, NY)
- …Bureau of Human Resources seeks to hire an Administrative Manager, NM/L-III (Senior Director , Office of Compliance Services). DUTIES WILL INCLUDE BUT NOT BE LIMITED ... existing employees are cleared utilizing the local and federal Medicaid compliance (OMIG and HHS) databases. Reviewing tasks and...& BUDGET APPROVAL" "This position MAY be eligible for remote work up to two days per week, pursuant… more
- Molina Healthcare (New York, NY)
- …to improve efficiency, productivity, effectiveness, and accuracy. * Works with the Director of Healthcare Analysis to develop and deploy an organizational strategy ... care administration degree **Preferred Experience** * State QI experience * Medicaid and/or Medicare QI + **Databricks** + **Development leading indicators and… more
- Molina Healthcare (New York, NY)
- …and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + Other tasks, duties, ... **Preferred Experience** + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. **Preferred License,… more
- Gentiva (Livingston, NJ)
- …Clinical Manager - Hospice - FT - Mon-Fri - 8a-5p** **Office Position - not remote .** **- 2 Years Hospice or Home Care Case Management Experience Required** **- 1 ... roles)** + **Tuition Reimbursement** You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will be responsible for… more
- VNS Health (Manhattan, NY)
- …that inform program management and committee decisions. * Work Flexibly: Enjoy a mostly remote work environment with just one day a month in the office, allowing you ... + Ensures regulatory compliance and timely processing for the Medicare and Medicaid appeal and grievance processes, incidents, quality of care concerns and any… more