• Medicaid Managed Care

    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
    Abbott House (10/19/24)
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  • Health Services Assistant

    New Directions Youth and Family Services (Lockport, NY)
    …the appropriate billing information and communicates any insurance concerns with the New Directions Medicaid Managed Care Liaison . 6. Documents all ... supporting the health and well-being of youth in our care . Your main job will be to transport youth...to community based medical providers and serving as a liaison between the provider and Health Services staff and… more
    New Directions Youth and Family Services (10/19/24)
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  • Medicaid Tribal Liaison - MED

    Idaho Division of Human Resources (ID)
    …staff in determining trends and resolving technical problems. + Works with Idaho Medicaid managed care organization tribal coordinators. + Develops and ... position will serve as the Idaho State Medicaid Program's liaison with Indian Health Care Providers (IHCPs) and Tribal representatives. The liaison will… more
    Idaho Division of Human Resources (10/25/24)
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  • Executive Director, Office of Mail Renewal (OMR),…

    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 (10/25/24)
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  • Director of Medicaid Long Term Care

    New York State Civil Service (Albany, NY)
    …the successful direction of mid and high level professional staff is desirable. Experience with Managed Long Term Care and/or Medicaid Fee For Service long ... HELP No Agency Health, Department of Title Director of Medicaid Long Term Care Policy (Health Program...and Department of Labor. They will be the primary liaison with the DOH Division of Legal Affairs on… more
    New York State Civil Service (09/28/24)
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  • Compliance Officer Medicaid , IN - Hybrid,…

    McLaren Health Care (Indianapolis, IN)
    …of the Indiana Medicaid programs in which MDwise serves as a managed care entity (MCE). The Compliance Officer facilitates communication between federal and ... the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and...experience and knowledge of HMO, PPO, TPA, PHO and Managed Care operational functions. + Candidate must… more
    McLaren Health Care (10/18/24)
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  • Medicaid Unit Supervisor

    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
    City of New York (10/16/24)
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  • RN Utilization Management Nurse Sr.…

    Elevance Health (Tampa, FL)
    …the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, ... RN Utilization Management Nurse Sr. ( Medicaid -InPatient) JR130851 **Location:** Must be within 50 miles...acute care clinical experience, utilization management or managed care experience; or any combination of… more
    Elevance Health (10/01/24)
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  • Customer Solution Center Even MORE Service…

    LA Care Health Plan (Los Angeles, CA)
    …in a corporate setting. Demonstrated experience handling complex customer calls. Preferred: Managed care or healthcare experience. Skills Required: Strong verbal ... meet all regulatory requirements for Centers for Medicare and Medicaid Services(CMS), and for SPD population. * Contacting members...member contact, including potential care coordination/continuity of care issues. (20%) Liaison to meet LA… more
    LA Care Health Plan (10/30/24)
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  • Medicaid Program Advisor

    Staffing Solutions Organization (Albany, NY)
    Medicaid Program Advisor Albany, NY, USA Req #962 Thursday, August 1, 2024 Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC ... (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed...reflection of our clients and the people they serve. ** Medicaid Program Advisor - Albany, NY** **Item 1064** **Summary:**… more
    Staffing Solutions Organization (10/22/24)
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  • Medicaid Program Advisor - DPDM

    Staffing Solutions Organization (New York, NY)
    Medicaid Program Advisor - DPDM 1069 New York, NY, USA * Virtual Req #988 Monday, September 9, 2024 Staffing Solutions Organization LLC (SSO), an affiliate of Public ... LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed...reflection of our clients and the people they serve. ** Medicaid Program Advisor, Albany NY** **DPDM - 1069** **This… more
    Staffing Solutions Organization (08/22/24)
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  • Community Engagement Lead - Medicaid

    Wider Circle (Rockville, MD)
    …in operations and management within a healthcare setting (health plan, managed care organization, etc.) + Volunteer experience + Medicaid experience a plus + ... to motivate and support each other to get the care they need when and where they need it....Area Manager will be responsible for implementing and managing Medicaid programs as outlined by the Implementation and Leadership… more
    Wider Circle (10/22/24)
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  • Medical Director - Behavioral Health - Texas…

    CVS Health (Austin, TX)
    …least two (2) years of BH leadership experience in a government, health management, or managed care organization, and/or at least two (2) years of experience as ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...- Serve as a key health plan external facing liaison , regarding behavioral health initiatives, programs, and projects with… more
    CVS Health (08/27/24)
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  • Medical Outcomes Science Liaison - Phoenix…

    AbbVie (Denver, CO)
    …DO, Pharm.D. or Ph.D. + Three (3) to five (5) years of experience in a Managed Care /PBM, VA/DoD, CMS, State Medicaid , health care consulting, ... & Access department who uses clinical expertise and experience/ knowledge of managed care , health policy, and pharmacoeconomics to support AbbVie's scientific… more
    AbbVie (10/18/24)
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  • Quality Practice Liaison

    CVS Health (Tallahassee, FL)
    …leadership role in primary care setting or + Three years' experience in managed care with a focus on HEDIS and Quality with experience facilitating and ... (ABH) and its high-volume providers to facilitate high quality care for members. The Liaison achieves this...LPN or LISW or + Three years' experience in managed care with a focus on HEDIS… more
    CVS Health (10/23/24)
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  • Home Care Nurse Liaison

    Nuvance Health (Danbury, CT)
    …Connecticut. Make independent nursing judgements. Computer data input/keyboard operations. Knowledge of managed care operations, Medicare and Medicaid and ... clinical data from patient charts for insurance company queries. Provides managed care forms and/or patient education tools in admission chart, as necessary.… more
    Nuvance Health (10/18/24)
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  • Marketing Liaison (Regional Role)

    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
    Allaire Rehab & Nursing (10/12/24)
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  • Behavioral Health Clinical Liaison

    CVS Health (Richmond, VA)
    …+ Ability to work independently + 2+ years experience required working for a managed care organization (MCO). **EDUCATION** + If an LPC, LCSW, LMFT, BCBA, ... Friday 8-5 with occasional on call holiday weekend coverage required.** **The BH Clinical Liaison ** is a clinical leader in the Medicaid plan focusing on… more
    CVS Health (10/26/24)
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  • Hospice Liaison Nurse -Weekender position

    Novant Health (Charlotte, NC)
    …three years' experience in home care or hospice, required. Previous experience in managed care , infusion care , and case management and previous home ... **Overview** Novant Health is seeking a Hospice Liaison Nurse. The Hospice Liaison Nurse... Nurse clinically assesses and admits patients to Hospice care as well as facilitates discharge planning from the… more
    Novant Health (10/30/24)
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  • TRICARE Community Liaison

    Humana (Portsmouth, VA)
    …caring community and help us put health first** The TRICARE Community Liaison (TCL)- is a customer-facing Humana Military associate who is knowledgeable, ... four MTFs. Through clear and concise communication, the **TRICARE Community Liaison (TCL)** is responsible for ensuring MTF, beneficiary, and provider understanding… more
    Humana (11/02/24)
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