• Medicaid Managed Care

    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
    Abbott House (10/19/24)
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  • Director of Medicaid Long Term Care

    New York State Civil Service (New York, NY)
    …the successful direction of mid and high-level professional staff is desirable. Experience with Managed Long-Term Care and/or Medicaid Fee For Service long ... HELP No Agency Health, Department of Title Director of Medicaid Long Term Care Policy (Health Program...and Department of Labor. They will be the primary liaison with the DOH Division of Legal Affairs on… more
    New York State Civil Service (09/28/24)
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  • Executive Director, Office of Mail Renewal (OMR),…

    City of New York (New York, NY)
    … with other agencies such as the NY State Department of Health (SDOH), NY Medicaid CHOICE/MAXIMUS, Managed Care Organizations (MCOs), the Office of ... the Executive Director, of the Office of Mail Renewal, Managed Care Program (MCP), and Third-Party Health...Organizations (MCOs) and case management providers through which eligible Medicaid clients access behavioral and health care more
    City of New York (10/25/24)
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  • Medicaid Unit Supervisor

    City of New York (New York, NY)
    …APPLICANTS MUST BE PERMANENT IN THE PRINCIPLE ADMINISTRATIVE ASSOCIATE CS TITLE The Home Care Services Program (HCSP) is a Medicaid funded program that provides ... daily living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the...and guidelines. - Participate in meetings and act as liaison with MAP staff involved in developing Medicaid more
    City of New York (10/16/24)
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  • Medicaid Program Advisor - DPDM

    Staffing Solutions Organization (New York, NY)
    Medicaid Program Advisor - DPDM 1069 New York, NY, USA * Virtual Req #988 Monday, September 9, 2024 Staffing Solutions Organization LLC (SSO), an affiliate of Public ... LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed...reflection of our clients and the people they serve. ** Medicaid Program Advisor, Albany NY** **DPDM - 1069** **This… more
    Staffing Solutions Organization (08/22/24)
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  • Marketing Liaison (Regional Role)

    Allaire Rehab & Nursing (Edison, NJ)
    …+ Maintain a working knowledge of Federal and State regulations and reimbursement ( Managed Care , Medicare, and Medicaid ). + Provide assistance with ... Allaire Health Services is looking for a Marketing Liaison to join our incredible New Jersey team!...admissions process. + Maintain a strong working knowledge of managed care referral processes. + New Jersey… more
    Allaire Rehab & Nursing (10/12/24)
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  • Senior Healthcare Program Specialist - Social…

    Staffing Solutions Organization (New York, NY)
    …accordance with State and Federal guidelines. **Responsibilities include:** + Act as a liaison between the Social Care Networks and other stakeholders. This ... Senior Healthcare Program Specialist - Social Care & Community Supports New York, NY, USA...LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed… more
    Staffing Solutions Organization (11/09/24)
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  • Casa Director

    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
    City of New York (09/15/24)
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  • Senior Contracting Performance Analyst

    Mount Sinai Health System (New York, NY)
    …and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's ... work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is...to drive performance for value-based contracts for Medicare Advantage, Managed Medicaid and Commercial arrangements. * Support… more
    Mount Sinai Health System (09/06/24)
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  • Audit Reviewer

    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 (10/28/24)
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  • Unit Clerk

    City of New York (New York, NY)
    …medication and other health care services at little or no cost. MAP Managed Care Client Services (MCCS) - Restricted Recipient Program (RRP) Unit imposes ... within MAP to ensure appropriate delivery of services to clients enrolled in managed care . - Type correspondences, reports and other written materials. -… more
    City of New York (08/14/24)
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  • Case Manager NYSNA Line

    BronxCare Health System (Bronx, NY)
    …and practice patterns as required. - Acts as patient advocate. - Dialogues with home care liaison practitioner or managed care organization. Follows up ... transition through all levels of care . - Maintain knowledge of Managed Care requirements, DRG, insurance benefits, IPRO regulations and nationally recognized… more
    BronxCare Health System (09/18/24)
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  • Field Monitor, Quality Control Unit

    City of New York (New York, NY)
    …individuals in a variety of settings to promote independence and well-being. The Home Care Services Program (HCSP) is a Medicaid funded program that facilitates ... 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 (09/27/24)
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  • Regional Medical Director

    FlexStaff (New York, NY)
    …CMO. Outcomes Management: + Have a good understanding of population health and managed care principles. + Identifies opportunities and develops programs to ... position description established by the PACE organization before working independently. Managed Care and Clinical Design: + Understand utilization management… more
    FlexStaff (10/18/24)
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  • Director of Policy & Legal/ Healthcare…

    City of New York (New York, NY)
    …of public and commercial payors at the federal and state levels, and the evolution of managed care - Value-based care and Alternative Payment Models. - Price ... the most impacted NYC communities. CHECW addresses inequity across community and health care systems in partnership with community, faith-based, and health care more
    City of New York (10/28/24)
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  • Hedis Specialist

    TEKsystems (New York, NY)
    …measure medical record data abstraction requirements * An emphasis in Medicare or Medicaid /Medi-Cal managed care Skills: Hospital billing, Ambulatory, audit, ... research and medical record review * Act as HEDIS liaison to providers at which reviews are performed *... managed care , medical charts, data abstraction Top Skills Details: Hospital… more
    TEKsystems (11/02/24)
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  • Reconciliation Representative

    Hackensack Meridian Health (Hackensack, NJ)
    …patient accounting/revenue cycle operations or relevant experience/training. + Demonstrated knowledge of Managed Care Contracts, Medicare, and Medicaid . + ... accuracy and proper revenue recognition. + Acts as a liaison with other departments to adjust or reconcile financial...verifies validity of daily credit card chargeback. + Reconciles Managed Care , Medicare and other Governmental payments… more
    Hackensack Meridian Health (10/11/24)
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  • Medical Management Specialist I

    Elevance Health (New Hyde Park, NY)
    …Experience working with the Medicaid population is preferred. + LTSS or managed care organization experience is preferred. + Previous LTSS experience is ... when requested. + May assist with complex cases. + May act as liaison between Medical Management and/or Operations and internal departments. + Maintains and updates… more
    Elevance Health (11/04/24)
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  • Data Science Analyst I-Geriatric and Palliative…

    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 ... is 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 (10/17/24)
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  • Behavioral Health Clinician - Full Time

    Atlantic Health System (Morristown, NJ)
    …schedules, statistics, re-certification information. Maintains accurate & timely record of insurance/ managed care data and other such functions. Meets designated ... with ECT nursing regarding clinical and medical aspects of patient care . Establish and review treatment discharge recommendations 4. Provides clear, accurate… more
    Atlantic Health System (11/08/24)
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