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MetroPlus Health's 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.
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If you're a proficient Registered Nurse with a minimum of two (2) years of recent experience in a home environment within the past fifteen (15) years , this could involve working with a Certified Home Health Agency (CHHA), Licensed Home Care Service Agency (LHCSA), Managed Long Term Care (MLTC), or experience in home care as a paraprofessional (e.g., Home Health Aide or Licensed Practical Nurse (LPN), including Private Duty Nursing , we invite you to submit your application.
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Overview:The Adult Protective Services Litigation and Program Counseling Unit represents the agency with respect to support for the Home Care Services Program, the HIV and AIDS Services Administration (HASA), Adult Protective Services (APS), the Medical Assistance Program (MAP), and the Medicaid Managed Care Program.
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Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health.
$93,000 a yearPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Develops and maintains current knowledge of state and federal regulatory requirements related to all aspects of grievances and appeals for Medicare managed care organizations, Medicaid, home health care, managed long term care as well as contractual requirements.
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Scope, sell, and deliver commercial data projects, which can include but are not limited to market sizing/ segmentation, provider profiling/targeting, provider affiliation mapping, epidemiology studies, managed care analytics, pull-through modeling / program design, forecasting, field force design, and incentive comp.
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Minimum of 2 years' home setting experience, including work with CHHAs, LHCAs, MLTC, or as a paraprofessional (e.g., HHA, LPN and/or Private Duty Nursing). This role is dynamic and hybrid, centered around the vibrant Bronx area in the heart of New York City. You'll be diving into consumer homes and conducting assessments through cutting-edge telehealth methods, making every day a thrilling adventure.
$100,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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RiverSpring Living provides a full range of care solutions including nursing home care, managed long-term care, assisted living programs, senior housing, rehabilitation services and specialized services such as elder abuse prevention and memory care.
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The Adolescent Medicine Attending Physician will work collaboratively with the MSAHC Medical and Deputy Medical Directors of Primary Care and Mental Health to ensure that the delivery of primary and reproductive health care to young people is developed and managed in accordance with MSAHC's mission, strategic direction and business position, Mount Sinai's policies and procedures, New York State regulations and guidelines, funder guidelines, and established best practices in adolescent medicine.
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In this role, you will be scheduled for in person appointments with members of the long term care population, who are applying for Managed Long Term Care services (MLTC). In this role, you will be responsible for independent review and evaluation of completed UAS reassessments for appropriateness of long-term care services for consumers, in accordance with Medicare and Medicaid guidelines.
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Responsibilities Must be able to understand managed care contracts, create project spreadsheets for submission to payers, write reconsideration appeals and send to MCOs, and be able to communicate both internally and externally for resolution of claim disputes.
$68,900 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Working under the direct supervision of the Director of Managed Care, Central Office, the Assistant Coordinating Manager/Provider Enrollment will be responsible for the managed care provider enrollment across two to four Health + Hospitals acute care facilities.
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Identify information to the Primary Care Physician (PCP), specialist and members of the patient's care team. Long-Term Care (MLCT), Managed Care Organization (MCO), etc.
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Supports data accuracy, compliance processes, packaging preservation, proper binning, issuing, receiving and shipping of material managed in the stores operation. Family care assistance through fertility support , surrogacy and adoption assistance , lactation support , subsidized bac k-up care , and programs that help with loved ones in all stages.
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Our engagements are typically focused on growth solutions that leverage cutting edge assets and expertise, revenue cycle management capabilities across the value chain to ensure maximum value capture, or pricing capabilities that enable providers to excel along the full managed care contracting life cycle.
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care managed of jobs in Brooklyn, NY
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