- 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 (New York, NY)
- …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
- Molina Healthcare (Yonkers, NY)
- …assuming technical and project leadership roles. * May function as a technical consultant or researcher. * Considered a SQL GURU. * Leads in gathering requirements, ... background * 3-plus years managed care experience, preferably working with the Medicaid product * Knowledge of state encounter submission process. * Knowledge of… 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