- 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)
- …+ 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
- Allaire Rehab & Nursing (Edison, NJ)
- …+ Maintain a working knowledge of Federal and State regulations and reimbursement ( Managed Care , Medicare, and Medicaid ). + Provide assistance with ... Allaire Health Services is looking for a Marketing Liaison to join our incredible New Jersey team!...admissions process. + Maintain a strong working knowledge of managed care referral processes. + New Jersey… 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
- Staffing Solutions Organization (New York, NY)
- …accordance with State and Federal guidelines. **Responsibilities include:** + Act as a liaison between the Social Care Networks and other stakeholders. This ... LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed...NYC** **DPDM - 1083** **Summary** The Bureau of Social Care and Community Supports works to integrate health and… more
- Mount Sinai Health System (New York, NY)
- …and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's ... work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is...to drive performance for value-based contracts for Medicare Advantage, Managed Medicaid and Commercial arrangements. * Support… 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
- 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
- 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)
- …and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PR** **E** **FE** **R** **RED L** ... **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and… more
- BronxCare Health System (Bronx, NY)
- …and practice patterns as required. - Acts as patient advocate. - Dialogues with home care liaison practitioner or managed care organization. Follows up ... transition through all levels of care . - Maintain knowledge of Managed Care requirements, DRG, insurance benefits, IPRO regulations and nationally recognized… 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
- CenterLight Health System (Ridgewood, NY)
- …CMO. Outcomes Management: + Have a good understanding of population health and managed care principles. + Identifies opportunities and develops programs to ... position description established by the PACE organization before working independently. Managed Care and Clinical Design: + Understand utilization management… more
- VNS Health (Manhattan, NY)
- …required + Knowledge of federal and state health care regulations related to Medicare, Medicaid , managed care , and long term care preferred + ... OverviewCoordinates enrollment assessment and reassessment activities for VNS Health Managed Long Term Care plan and other health plans, as needed. Works under… more
- Centene Corporation (New York, NY)
- … products, including options available through the New York State of Health (NYSOH), Medicaid Managed Care , Child Health Plus, Medicare, MLTC, FIDA, and ... and assisting with enrollment in various health plans, including Medicaid , Medicare, and other Fidelis Care products....to educate members on Wellcare products, acting as a liaison between members and various Fidelis and Wellcare departments.… 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)
- …Abilities Preferred** : + Bachelor's degree. + Experience in healthcare. + Knowledge of Managed Care contracts, Medicare, and Medicaid . + Proficient in SMS, ... to Patient Accounting, Case Management, Health Information, Clinical, Training, Managed Care and IT. Duties performed are...in revenue flow and discusses solutions. Acts as a liaison between agencies and Reconciliation department to prevent AR… 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