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At least 2+ years of RN Case Management experience in managed care MLTC. Qualified candidates will have prior RN Case Management experience within Managed Care, Home Care or Hospital Case Management, bilingual Spanish language ability required.
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Minimum three years, 2 years of experience in home care or hospital or home care registration or managed care coordination of services. A Baccalaureate Degree from an accredited college or university in Business Administration, Community Health, Psychology or related discipline with one year of full-time experience in a supervisory or administrative capacity in business management systems, general administration, health care and medical/patient systems administration.
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Under the direction of the Director of Admissions & Director of Utilization Review, the Utilization Review Specialist will coordinate Medicaid Managed Care benefits and approvals for clients receiving behavioral healthcare services from Odyssey House’s Part 820 residential programs.
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OVERVIEW OF THE COMPANYFox CorporationUnder the FOX banner, we produce and distribute content through some of the world’s leading and most valued brands, including: FOX News Media, FOX Sports, FOX Entertainment, FOX Television Stations and Tubi Media Group.
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Job Overview – Wound Care Nurse Manager, MLTC (RN): Join our client’s team in Bronx, NY, as a Wound Care Nurse Manager for their Managed Long-Term Care (MLTC) program. Industry Knowledge: Excellent knowledge of Department of Health and Managed Long-Term Care standards required.
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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.
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Position is Full- Time. Bilingual Spanish speaking with Homecare Experience; Exp. w/ HHA Exchange) Responsibilities: Conduct required on-boarding process for new hires (background checks; pre-employment physical; Home Care Registry Check) prior to start date.
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Clinical Support and Collaboration: Support OMH’s Hospital Care and Community Connections work to promote improved coordination of care and care transitions (including homeless, geriatric and rural issues), assist with OMH activities for the Medicaid Managed Care Program and other NYS regulated insurance programs and support mental health parity initiatives initiated by OMH. Support data driven implementation efforts led by the OMH Office of Population Health and Evaluation.
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True Care provides equal employment opportunities to all employees and applicants for employment without regard to race, religion, color, ethnic origin, gender, gender identity, age, marital status, veteran status, sexual orientation, disability, or any other basis prohibited by applicable federal, state, or local law.
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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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Perform medical intakes on all new NYPD and CE cases admitted to CARE and in collaboration with partner departments for animals admitted to veterinary partner hospitals, AAH, ARC, and Adoption Center as needed.
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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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Human Resources Solutions (HRS) is recruiting for one Clerical Associate IV to function as a Customer Care Representative, who will:-Respond to questions and inquires (via telephone and email) that require working knowledge of all HRS Operations, as well as other DSS-HRDHS programs, initiative, and communication.
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We are seeking a Utilization Review Nurse (LVN/RN) with strong clinical judgment to join our team at a Managed Care Organization in New York. In this role, you will play a pivotal role in ensuring high-quality, cost-effective care for patients, facilitating their journey towards maximum medical improvement while receiving medically necessary treatment.
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And referrals to medical specialists for follow-up care via Aftercare. Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.
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managed care banner jobs Title: medical in Brooklyn, NY
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