- New York State Civil Service (New York, NY)
- …ensuring the financial integrity of New York state's $94 billion Medicaid program by investigating healthcare providers, such as pharmaceutical companies, ... legal support analysts to conduct complex, long-term healthcare fraud investigations. The Medicaid program provides health coverage to millions of New Yorkers,… more
- City of New York (New York, NY)
- Job Description The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs, for the City of New York. Applying ... areas: Managed Care Client Services (MCCS), Recipient Restriction Program (RRP), and Comprehensive Medicaid Case Management...state managed care enrollment broker for the managed care program ) to ensure the operational integrity of… more
- Community Health Action of Staten Island (Staten Island, NY)
- …Director of Care Management is the lead manager and administrator for the Medicaid funded Health Home program . They collaborate with all departments to ... develop, deliver, and evaluate program services and oversee all operations. The ...services are provided to clients of the Health Home Medicaid Care Management Program in accordance with… more
- City of New York (New York, NY)
- …for Medicare, identifying Medicaid clients who should be part of buy-in program , and identifying SDOH Medicaid clients who should no longer have benefits. ... Services Accountability Office (DSS-AO) is responsible for supporting the integrity of social services programs administered by the New...Staff Analyst NM III to function as an Executive Director , Data Analytics & Verification who will: - Oversee… more
- Molina Healthcare (New York, NY)
- …and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality ... of the criteria for medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …for the development and implementation of the Children's Behavioral Health (BH) Carve-In program . The Medical Director for BH Children's Services has overall ... accountability for BH services for all Medicaid Managed Care enrollees under age 21 years. Essential...Leads, develops, and implements the Children's Behavioral Health Carve-In program following NYS directives and guidelines. + Completes medical… more
- City of New York (New York, NY)
- … Medicaid . SNT is recruiting for one (1) Executive Agency Counsel M2 to function as Director of the SNT Program will: - Serve as a legal advisor on complex ... Accountability Office (DSS AO) is responsible for protecting the integrity of social services programs administered by the New...for protecting against fraud and recovering Cash Assistance and Medicaid pursuant to SSL 104, 104-b, 369, and 42… more
- Vibrant Emotional Health (New York, NY)
- …social service programs + Candidates must be enrolled or eligible to enroll in NYS Medicaid Program w/in 30 days of hire (New York State: LMHC, LCSW, Licensed ... Job Title: Senior Director of Clinical Services Department: Community Services Reports...their community programs. + Support Vibrant culture through leadership integrity , transparent communication, and the demonstration of all Vibrant… more
- City of New York (New York, NY)
- …Services (DHS), as well as to Human Resources Administration's (HRA) operations and program services. OPMDA is requesting to hire one (1) Admin Staff Analyst NM-3 ... to function as the Executive Director , HRA Performance & Reporting, who will: - Oversee...the provision of analytic and data support to HRA's program areas, and the development of a consistent and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area ... medical policies, guidelines and medical criteria. + Assists with training medical director colleagues and nursing staff , including leadership of teaching grand… more
- City of New York (New York, NY)
- …public assistance programs, including Cash Assistance, the Supplemental Nutrition Assistance Program (SNAP), Medicaid , Domestic Violence Services, Home Care ... launching and managing new programs (eg, the Emergency Rental Assistance Program or ERAP); supporting Information Technology (IT) initiatives through various… more
- Planned Parenthood of Central and Western NY (Rochester, NY)
- Director of Finance Rochester, NY (http://maps.google.com/maps?q=114+University+Ave+Rochester+NY+USA+14605) * Finance Job Type Full-time Description Director of ... Board of Directors, government/legal contacts and other stakeholders as directed (eg Medicaid cost report, DOH reports, IRS filings, PPFA reports, etc.) + Works… more
- Molina Healthcare (NY)
- … integrity framework * Strategizes with cross functional teams on payment integrity program advancements and best practice development * Responsible to engage ... years relevant experience in special investigation units, Insurance Fraud and Abuse, Payment Integrity Program , Law Enforcement or Risk Management * Minimum 8-10… more
- The Arc Erie County NY (Buffalo, NY)
- …seeking a dedicated and compassionate Speech Therapist to join either our School Age program in Cheektowaga or Preschool program in Tonawanda! This position will ... etc.) Requirements + Successful completion of a Speech Language Pathologist program recognized by the Council on Academic Accreditation + Current licensure… more
- City of New York (New York, NY)
- …ELIGIBLE FOR 6.1.9. The Accountability Office (AO) is responsible for supporting the integrity of social services programs administered by the New York City Human ... financial information is uncovered or from referrals from other program areas requiring budgeting action on cases. Within the...on primary residences of recipients to obtain reimbursement of Medicaid or Cash Assistance. The unit also processes all… more
- The Arc Erie County NY (Buffalo, NY)
- …in the state of NY + Successful completion of a Physical Therapist program recognized by the Commission of Accreditation in Physical Therapy Education (CAPTE) + ... + Affordable health, dental, vision & life insurance + 403b retirement program w/ employer contribution + Flexible spending account (FSA) + Automatic paid… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and ... in interpreting managed care benefit plans and strong knowledge of government program contracts (Medicare and Medicaid ) and benefits, preferred. + Strong… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …in interpreting managed care benefit plans and strong knowledge of government program contracts (Medicare and Medicaid ) and benefits, preferred. + Strong ... set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address… more
- VNS Health (Manhattan, NY)
- …grievances and appeals on our behalf. * Data-Driven Decisions: Maintain the integrity of our case files and data collection systems. Prepare insightful reports ... and analyses that inform program management and committee decisions. * Work Flexibly: Enjoy...regulatory compliance and timely processing for the Medicare and Medicaid appeal and grievance processes, incidents, quality of care… more
- Palmyra-Macedon Central School District (Palmyra, NY)
- …+ Focus on students + Value the power of positive relationships + Act with integrity and honesty + Work with a purpose, striving for excellence, pride and passion + ... families and members of the community as an integral part of the educational program by: + Providing counseling service for all students. + Being available at the… more