- City of New York (New York, NY)
- …is recruiting for one (1) Principal Administrative Associate II, to function as a Medicaid Consultant within the Central Intake Unit, who will: - Interpret ... TITLE. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to...Medicaid policies and procedures for assigned cases for individuals… more
- Public Consulting Group (Trenton, NJ)
- …is changing, and PCG is at the forefront. We are looking for an experienced Medicaid Consultant to join our team and help lead our growth efforts. Deep ... new streamlined modular certification (SMC) and outcomes-based certification (OBC). Our ideal Medicaid Consultant will provide oversight and direction for scope,… more
- Public Consulting Group (Trenton, NJ)
- …Grants Management + Assessments and Feasibility Studies PCG is looking for a Senior Consultant in Medicaid policy and funding as it relates to children's ... and children's behavioral health services. PCG is looking for a Senior Consultant in Medicaid policy and funding as it relates to children's behavioral health… more
- VNS Health (Manhattan, NY)
- …analysis and interpretation designed to improve clinical outcomes. . Serves as consultant for unusual and difficult medical cases. Participates in the QARR/HEDIS ... Investigation Unit on issues related to Fraud, Waste, and Abuse of Medicare/ Medicaid services. + Collaborates with pharmacy services to review PBM activities and… more
- HealthEdge Software Inc (Trenton, NJ)
- **Overview** **Overview:** The Business Consultant leads and mentors the Service Delivery team in all Tier 1 (Basic) and Tier 2 (Intermediate) consulting ... products (from basic to advanced features/functionality), payment methodologies/policies (Medicare, Medicaid , and commercial), payment integrity, and healthcare plan operations… more
- Humana (Trenton, NJ)
- …in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, comprises the majority of ... leveraging core consulting skills to support delivering some of Medicare and Medicaid 's highest priority projects and initiatives, with an emphasis on Medicare… more
- Deloitte (Princeton, NJ)
- …Human Capital practice. Work you'll do As a Government Health Actuary - Consultant in Deloitte's Human Capital Actuarial and Insurance Solutions Practice, you will ... health plan/insurance company experience + 1 + years' experience with Medicaid managed care capitation rate development and/or fee-for-service rate development +… more
- City of New York (New York, NY)
- …with essential benefits such as Cash, Food and Rental Assistance as well as Medicaid . The Office of the Medical Director aims to improve the health and well-being ... one (1) City Medical Specialist (Per Diem) to function as a Medical Consultant who will: - Indirectly supervise contracted clinical staff, share policies and… more
- Highmark Health (Trenton, NJ)
- …share models and will be implemented for the Organization's Medicare Advantage, Medicaid , ACA, and commercial populations with the goal of maximizing quality while ... key provider partners. + Collaborate with and support the senior Strategic Partners Consultant role as needed + Other duties as assigned or requested. **EDUCATION**… more
- Public Consulting Group (Trenton, NJ)
- …programs that help customers achieve social and economic self-sufficiency, such as Medicaid , TANF, SNAP, workforce and infrastructure development. Some of our main ... that improve communities and support individuals. The team is seeking to add a Consultant that will help us fulfill this mission, particularly as we try to expand… more
- Public Consulting Group (Trenton, NJ)
- …intersection and overlap between our Special Education/Case Management and school-based Medicaid services work within a state; regularly engage with counterparts + ... clients + Understand and continually monitor Federal, state, and local Medicaid School-Based program policies and guidance, collaborating with PCG subject matter… more
- Public Consulting Group (Trenton, NJ)
- …setting and payment reform initiatives, including for federal entitlement programs including Medicaid and Title IV-E + Conducting financial and data analysis using ... with government and/or nonprofit finance office, accounting firm, consulting firm, Medicaid or other policy office + Bachelor's degree required, preferably with… more
- Elevance Health (Woodbridge, NJ)
- …provide an equivalent background. **Preferred Qualifications:** + Medicare and Medicaid experience preferred + Provider engagement experience preferred + Strong ... MS Excel experience preferred + Self-starter mentality is must Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to… more
- Atlantic Health System (Morristown, NJ)
- …- its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in 2020. Morristown ... Medical Center is a Magnet Hospital for Excellence in Nursing Service, the highest level of recognition achievable from the American Nurses Credentialing Center for facilities that provide acute care services. Our nonprofit hospital was also designated a Level… more
- Atlantic Health System (Morristown, NJ)
- …- its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in 2020. Morristown ... Medical Center is a Magnet Hospital for Excellence in Nursing Service, the highest level of recognition achievable from the American Nurses Credentialing Center for facilities that provide acute care services. Our nonprofit hospital was also designated a Level… more
- Prime Therapeutics (Trenton, NJ)
- …management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and ... state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each...discussion for these periodic meetings. + Acts as a consultant to Rebate Director for RFPs and implementations when… more
- Daiichi Sankyo Inc. (Basking Ridge, NJ)
- …not limited to, areas of GPO/PBM and trade/distribution agreements, Medicare, Medicaid , product pricing, and government price reporting. Coordination with, and ... **Responsibilities** - Lead drafting and negotiating contracts for commercial, Medicaid and Medicare coverage, as well as other government...support functions in an in-house capacity, as a legal consultant , and/or at a law firm in a practice… more
- Elevance Health (Woodbridge, NJ)
- …metrics to track performance and goal achievement. + Serves as internal consultant relative to continuous improvement initiatives. + Identifies and develops plans to ... Coder (CPC) and or professional coding experience preferred. + Medicare/ Medicaid /Commercial/Exchange line of business experience. + Travels to worksite and… more
- Atlantic Health System (Morristown, NJ)
- …activities and clinical research. + Serve as a clinical expert and leadership consultant to nursing, healthcare team members, and the larger community. Benefits + ... - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in 2020. Morristown… more
- Atlantic Health System (Morristown, NJ)
- …crisis intervention and community resource knowledge and skill. 4. Serves as consultant to emergency department staff in identifying patient problems and disposition ... - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in 2020. Morristown… more