- 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
- 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
- Deloitte (Stamford, CT)
- …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
- Molina Healthcare (Yonkers, NY)
- …urgency, communication and follow through to closure. * Knowledgeable of State Medicaid contract Service Level Agreements. Demonstrates SME knowledge of MCO contract ... compliance requirements that impact processes. * Facilitates and leads processes and activities to complete deliverables impacting assigned healthplans including, but not limited to, RFP Responses, audit response/coordination, and evaluation of new contract… more
- VNS Health (Manhattan, NY)
- …and ensure compliance. + Abstracts medical data from medical records assigned to consultant in a precise and proficient manner + Accesses scanned copies of medical ... required + Minimum of one year quality improvement experience in Medicare, Medicaid or Commercial Health Plan Knowledge of HEDIS/QARR standards, medical terminology,… more
- Nuvance Health (Danbury, CT)
- …carve out exclusion to identify specific implantable devices. c. Acts and a consultant to Service Lines and Business United to ensure an accurate Soarian Financials ... understand all ancillary charging and department functionality. 6.Knowledge in Managed Care, Medicaid and Medicare and payment methodologies to ensure charging is in… more