- Mount Sinai Health System (New York, NY)
- …The team includes 400+ employees with clinical, contracting, finance, IT, analytics, operations , and product development expertise. MSHP is a fast growing business ... the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1)...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- Mount Sinai Health System (New York, NY)
- …is responsible for evaluating and driving performance for value-based contracts including Medicare , Medicaid and commercial arrangements. The Senior Director is ... for value-based contracts inclusive of risk and opportunity identification for Medicare , Medicaid and Commercial arrangements. 2. Develop strategies and alternatives… more
- New York State Civil Service (Queens Village, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Associate Director of Training 1- Mental Hygiene Occupational Category Health Care, Human/Social ... of permanent, contingent permanent, or 55 B/C service as an Associate Director Training 1 (Mental Hygiene).Non-Competitive Promotion (NCP):NOTE: If three or fewer… more
- City of New York (New York, NY)
- …for (1) Administrative Staff Analyst NM III to function as an Executive Director , Data Analytics & Verification who will: - Oversee the management, administration, ... and data sharing methods and/or tools that drive DSS-AO operations , and other Agency program areas (eg FIA, MICSA,...work includes identifying Medicaid clients who should apply for Medicare , identifying Medicaid clients who should be part of… more
- Nuvance Health (Danbury, CT)
- …Coordinators, and Insurance companies. Sends provider appeals to insurance companies including Medicare and Medicaid for entire network. Provides support in all the ... denials to nurses in a timely manner. 5. Creates a weekly assignment for director to review for appeals. 6. Communicates with insurance companies to schedule a… more
- Option Care Health (Ridgewood, NY)
- …care is maintained. The Regional Manager of nursing is responsible for assisting the Sr./ Director , Operations and/or Area Director of Nursing in meeting ... with the pharmacy manager in the absence of the Sr./ Director , Operations . Serves as the Administrator and/or... of Nursing of the home health agency per Medicare Conditions of Participation definition. Serves as Facility Infection… more
- VNS Health (Manhattan, NY)
- …for VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Fully Integrated Dual Advantage (FIDA) and Select Health. Ensures ... and accuracy standards are met. Coordinates efficient functioning of day-to-day operations according to defined processes and procedures. Creates and maintains… more
- VNS Health (Manhattan, NY)
- …VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Ensures regulatory compliance, timeliness requirements and ... accuracy standards are met. Coordinates efficient functioning of day-to-day operations according to defined processes and procedures. Creates and maintains accurate… more
- VNS Health (Manhattan, NY)
- …Plans is seeking a dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our grievance and appeals processes. You will play a crucial role in ... staff handling grievances and appeals across our Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health product lines. * Ensure Compliance: Stay… more
- City of New York (New York, NY)
- …Manager who will, under the general direction of the Excess Income/Surplus Director , with wide latitude for the exercise of independent initiative and judgment ... Excess Income's Under-care renewals, Pay-In, e-Faxe, Provider Bills, Constituent inquiries, Medicare Saving Program (MSP) and Pooled Trust units. Receive cases from… more
- Sodus Rehab & Nursing Center (Tarrytown, NY)
- Full job description Position Overview: As the Accounts Receivable Director for our nursing home billing office, you will be responsible for overseeing all aspects ... Schedule: + Day shift + Monday to Friday Key Responsibilities: + Billing Operations Management: + Direct and supervise the billing team in processing claims,… more
- Nuvance Health (Danbury, CT)
- …nursing judgements. Computer data input/keyboard operations . Knowledge of managed care operations , Medicare and Medicaid and other payer sources. Deals with ... referred for care, to include an in-depth knowledge of Medicare , private insurance, HMO and Title 19 and all...duties as assigned by the Clinical Supervisors or Executive Director . 9. Fulfills all compliance responsibilities related to the… more
- Bristol Myers Squibb (New York, NY)
- …within the assigned territory. The CMAM will report into the East Region Director , Cell Therapy Market Access Managers. The individual is required to achieve all ... Therapy Account Management Team, Payer Account Executives, Cell Therapy Patient Operations , Cell Therapy Patient Support Services, Cell Therapy Access Strategy Team,… more
- Nuvance Health (Norwalk, CT)
- …required documentation to next level of care. 5. Issues Important Message for Medicare as requested. 6. Prepares/faxes electronic medical record for QIO appeals. 7. ... customers receive verification that their calls have been received. 15. Assists director when requested with procuring information for audits or performing special… more
- Mount Sinai Health System (New York, NY)
- …of experience in a clinical healthcare environment. Experience in clinical operations and/or experience working in performance improvement, patient safety, risk ... - MSH, Mount Sinai Hospital **Responsibilities** In collaboration with Senior Director of Regulatory Affairs, and other system leadership, directs and facilitates… more