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Refer elders to other programs when appropriate, which may include Medicaid Waiver, Respite, Managed Care, Supportive Housing, or other relevant resources. Work in collaboration with other CBES Departments to ensure timeliness and quality of care delivery as set by the EOEA regulation, Central of Medicare and Medicaid (CMS) Quality Measures, and Agency policy.
Full-timeExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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About NYC Health + Hospitals Metro Plus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, Metro Plus Gold, Essential Plan, etc.
$150,000 - $157,236 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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In conjunction with the VP of Managed Care Contracting & Payor Relations/legal department, reviews and negotiates any new 340B contracts and renegotiation of existing transaction fees. Continually monitors 340B regulations to ensure federal compliance, staying up to date on all rule changes, including HRSA/OPA, Medicaid and manufacturer changes.
$65,000 - $85,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
$64,579 - $80,723 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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The candidate in this position will provide HEOR & RWE presentations, clinical presentations as necessary, conduct collaborative research, and enter into evidence-based medicine discussions with healthcare providers, RWE researchers, managed markets medical and pharmacy directors, quality improvement specialists, hospital and managed care formulary decision makers and consultant pharmacists, state Medicaid and Medicare decision makers, guideline developers and others.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Case Manager must have minimum of two (2) years of case management experience assigned to Long-Term Managed Care Medicaid Waiver program and successfully complete all required trainings.
$20 an hourFull-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines.
Starting at $161,914.25 - $315,732.79 a year depends on education, experienceFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Acts as an advisor and consultant in the establishment of operational policies of the practice to include: (1) Purchasing and capital allocations; (2) Managed care plan participation; (3) Budget and practice expenses; (4) Medicare/Medicaid participation; (5) Billing and collection of professional fees; (6) Personnel management and related policies; (7) Risk management and quality assurance; and (8) Coding compliance.
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Negotiate pharmacy network reimbursement ethically in support of Navitus mission to meet or exceed clients and Navitus needs for all lines of business and programs, including Commercial, Medicare Part D, Managed Medicaid, Exchanges, and Narrow Retail, Specialty, and Mail Order Networks.
Full-timeRemoteExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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To support the Mission of Helio Health, Inc., the Health Home Plus Care Manager will provide comprehensive care management and coordination of services to Health Home enrollees and eligible Medicaid/Medicaid Managed Care community members.
$21.6 an hourFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Neurologist needed for a physician-owned and managed practice in Queens, NY. Job Function: Neurologist will cover multiple clinical locations on an outpatient-only basis No on-call responsibilities, standard business hours and flexible scheduling Patients who come through the disability, workers compensation program must undergo primary care, general health assessments, often neurological and sometimes a mental health assessment.
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We accept most health insurance plans including Medicaid and Medicaid Managed Care. Everything that affects your child's growth, development, education and well-being is of our utmost concern.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Must possess a thorough understanding of Medicare, Medicaid, Private Insurance, Managed Care costing and analysis, personnel management, accounts receivable/collections, resident funds, accounts payable, general ledger, and management of information systems.
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Must have one-year experience in long-term care billing with a working knowledge of Medicare, Medicaid, PPS, Managed Care Organizations, and private insurance. O'Brien Memorial Health Care Center - Masury, OH.
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As a part Ohio Medicaid’s effort to launch the next generation of Medicaid, ODM will implement OhioRISE (Resilience through Integrated Systems and Excellence), a specialized managed care program for youth with complex behavioral health and multi-system needs.
Full-timeExpandApply NowActive JobUpdated 3 months ago
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