- 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
- New Directions Youth and Family Services (Randolph, NY)
- …actions and conduct concerning safety and healthy working conditions. POSITIONS SUPERVISED: LPN, RN, Medicaid Managed Care Liaison , Medicaid ... dedicated to ensuring the well-being of youth in our care . You'll oversee the delivery of health and psychiatric...manage a skilled team of healthcare professionals, and coordinate care in compliance with state and organizational standards. This… more
- Ochsner Health (New Orleans, LA)
- …but not limited to analytics, IS, legal & compliance. + Acts as a liaison to commercial and Medicare payors, CMS, Medicaid and other governmental agencies ... to commercial payors, Medicare Advantage, Medicare Shared Savings Program, and Medicaid value-based programs. Guides the company's progress toward compliance success… 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
- CDPHP (Albany, NY)
- …and mail. The Medicaid Special Programs Case Manager typically works in the telephonic managed care setting but may be called on to work from a variety of ... clinical experience is required. + Previous experience working with Medicaid Long Term Care Programs preferred. +...patients with social needs preferred. + Experience in home care , medical office setting, or managed health… more
- OLV Human Services (Lackawanna, NY)
- …members to carry out the responsibilities within our Foster Care contracts and Medicaid Managed Care Plans assisting with any client and family needs ... Foster Care Coordinators of the contracted MMCPs ( Medicaid Managed Care Plans) in...**Essential Job Duties:** 1. Coordinate with the MMCP's foster care liaison /coordinator 2. Will attend all meetings… more
- Prime Therapeutics (Columbus, OH)
- …or within Medicare/ Medicaid (eg insurance, government program operations, managed care practices, and/or provider contracting) + Paralegal certification ... we make. **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior Contract Representative is responsible for contract… more
- Wider Circle (Baltimore, 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
- AmeriHealth Caritas (Columbia, SC)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... local law enforcement agencies. **Other Skills: ;** + Health care industry and/or Medicare/ Medicaid /Pharmacy/Behavioral Health/Pharmacy Benefit Management… more
- AbbVie (North Chicago, IL)
- …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
- AmeriHealth Caritas (Charleston, SC)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... and communication for network providers and acts as a liaison with the provider community. + Ensures compliance with...+ 3 years of supervisory/management/leadership experience, preferably in a managed care organization setting. + Must be… more
- Molina Healthcare (Detroit, MI)
- …process and to ensure the provision of Behavioral Health (BH) as a benefit of managed care . * Participates in community BH meetings that include the plan, ... care management programs. **Job Duties** * Serves as liaison between plan and community Mental Health and Alcohol...on BH and community service organization/county agency training on Managed Care . * Collaborates with UM and… more
- 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 (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
- 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
- CVS Health (Richmond, VA)
- …etc.) **Preferred Experience:** + 2+ years experience preferred working for a managed care organization (MCO). + Experience in completing utilization management ... 8-5 with occasional holiday weekend utilization management coverage required.** **The BH Clinical Liaison ** is a clinical leader in the Medicaid plan focusing on… more
- 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 ... Job Summary 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
- Centers for Independence (Milwaukee, WI)
- …**Knowledge, Skills, & Abilities:** + Some understanding of long-term care , disabilities, Medicaid , managed care and/or Medicare is preferred + Ability ... **IRIS Participant Liaison ** **Job Details** **Job Location** iLIFE Main -...Social Services **Description** **Job Purpose** : The IRIS Participant Liaison ensures optimal service is provided to participants, participant-hired… more
- MyFlorida (Tallahassee, FL)
- …'s managed care programs, with a focus on the Statewide Medicaid Managed Care (SMMC) program. The bureau's primary responsibility is ensuring ... Manager and the lead point of contact for assigned Medicaid managed care plan contract(s)....maintaining appropriate and up-to-date contract files, and serving as liaison with assigned contract vendor(s). The incumbent plans, organizes… more