- 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
- Teva Pharmaceuticals (Parsippany, NJ)
- …a Pharmaceutical and/or med Device company , state and/or state agency or as Medicaid consultant or equivalent work experience Experience Preferred: + Minimum of ... Medicaid Claims Analyst Date: Jan 22, 2025 Location:...our journey of growth! **The opportunity** **Position Summary:** The Medicaid Claims Analyst is responsible for Medicaid … more
- Teva Pharmaceuticals (Parsippany, NJ)
- …a Pharmaceutical and/or med Device company , state and/or state agency or as Medicaid consultant or equivalent work experience Experience Preferred: + Minimum of ... Medicaid Claims Analyst Date: Jan 6, 2025 Location:...our journey of growth! **The opportunity** **Position Summary:** The Medicaid Claims Analyst is responsible for Medicaid … 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
- 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
- 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
- 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
- New York State Civil Service (Middletown, NY)
- …coordinates care and treatment planning for individuals.a. Serve as a clinical consultant to multiple treatment teams within the assigned area.b. Attend Life Plan ... eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining eligibility. If you… more