- 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
- 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 (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
- VNS Health (Manhattan, NY)
- …preferred + Knowledge of the Community Medicaid process, including eligibility for managed long term care and the relevant coverage codes set by NYS ... Obtains and processes referrals to a network of contracted Managed Long Term Care (MLTC) plans. +...the time frame before they become eligible for community Medicaid . + Coordinates the effective date of community … 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
- 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)
- …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
- Molina Healthcare (New York, 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
- FlexStaff (Bayside, NY)
- …years in care /case management, disease management, or related fields (preferably within managed care , home care , or community health organizations). - At ... the Care Delivery Department to authorize personal care hours, aligning with participant needs and Medicaid...2+ years of experience in Managed Long-Term Care (MLTC) or Managed Care … more
- 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
- Hackensack Meridian Health (Hackensack, NJ)
- …and growth. 10. Extensive knowledge and experience in both healthcare delivery and managed care . 11. Intimate knowledge of, and experience in state regulatory ... 35. Facilitates assessment of patient concerns and complaints related to physician/clinical care . 36. Serves as liaison and represents Hackensack University… more
- City of New York (New York, NY)
- …commercial payors at the federal and state levels, and the evolution of managed care . The regulation and financing of community-based organizations (CBO's) at ... transparency, All-Payer Claims Databases, and other employer-led strategies promote high-value care . Medicaid policy and strategy. Budget management experience… 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
- VNS Health (Manhattan, NY)
- …operations experience. required + Minimum of two years of management within a managed care environment required + Experience marketing to a culturally diverse ... Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for qualifying degrees +...preferred Work Experience: + Minimum of five years of managed Medicare and/or Medicaid sales or equivalent… more
- Catholic Health Services (Melville, NY)
- …(ie, Access\MS-SQL); EPIC, and other reporting and database tools. Sound knowledge of Medicaid , Medicare and managed care requirements Must be Self-directed ... and quarterly reports reflecting accurate departmental data Works with Revenue Cycle and Managed Care teams to identify and resolve issues related to timely… more
- VNS Health (Manhattan, NY)
- …+ Minimum five years of experience in clinical medicine, including three years in managed care , and application of evidence based medical necessity criteria and ... programs + Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for qualifying degrees + Opportunities for… more
- 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
- CAMBA (Brooklyn, NY)
- …+ Provide all required information for weekly/monthly/quarterly/annual reports (eg # of clients in managed care programs, # of clients housed, etc). + Act as ... Health Home program is an innovative new model of care management focused on improving the health outcomes for...clients' eligibility for program and make file copies (eg Medicaid status and confirmation of HIV status). + Assist… 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
- 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