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Maintain liaison with other agencies such as the NY State Department of Health (SDOH), NY Medicaid CHOICE/MAXIMUS, Managed Care Organizations (MCOs), the Office of Medicaid Inspector General (OMIG), other MAP and HRA officials, and other governmental and private agencies/parties who are concerns with matters involving the delivery of essential services to Medicaid eligible consumers.
$81,659 - $122,432 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.
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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.
$60,000 - $70,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Long-term care and utilization management of MLTC and personal care services (PCS) for Medicaid managed care. 3-5 years of experience required in Care Management and/or Managed Care.
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Work in collaboration with the hospital departments such as Revenue Management Initiatives (RMI) to ensure charges are appropriately set to maximize reimbursement and mitigate lesser of contract terms in the Managed Care contract.
$97,589.96 - $162,649.75 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Compass Healthcare Consulting & Placement is conducting a search for a Full Time Remote - NYS LMSW Social Work Care Manager for our client a Managed Long Term Care Plan. Qualified candidates will have a NYS LMSW and prior LMSW Care Management experience from a Managed Long Term Care Plan (MLTC.
Full-timeRemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health network includes over 27,000 primary care providers, specialists and participating clinics.
$50,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Knowledge of Centers for Medicare & Medicaid Services (CMS) or New York State Department of Health (NYSDOH) regulations governing medical management in managed care. Experience in managed care, case management, identifying alternative care options, and discharge planning.
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In this role, the successful candidate The Senior Contract Manager-Managed Care assists with the development and implementation of managed care strategy for NYU Langone Hospitals Tisch, Orthopedic, Brooklyn Long Island and Long Island Community Hospital at NYU Langone Health including all Article 28 freestanding facilities such as the Perlmutter Cancer Center, NYU Langone Home Care and the Long Island Community Hospital Hospice.
$97,589.96 - $162,649.75 a yearFull-timeExpandUpdated 1 month ago - UpvoteDownvoteShare Job
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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.
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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.
$80,000 - $85,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Oversee and/or coordinates care with managed care organizations of identified clients who need either direct or indirect case supervision from a licensed mental health counselor.
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To excel in the role of Care Manager at Village Care, candidates must possess a valid NYS RN License and a minimum of 3 years of relevant experience in Managed Care, Home Care, or Community settings.
$93,000 - $105,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Knowledge of NYS Article 29-I health facility and Medicaid Managed Care regulations for youths in foster care. Oversee processing of invoices from hospitals and other community providers which require missing Medicaid Managed Care member ID information for services reimbursement.
$85,000 - $90,000 a yearFull-timeExpandUpdated 1 month ago - UpvoteDownvoteShare Job
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Develop effective working relationships with NYC agencies, NYS Office of Medicaid Inspector General, NYS Department of Health, NYS Office for the Aging, and Managed Long Term Care (MLTC) plans.
Full-timeExpandApply NowActive JobUpdated 4 days ago
care managed of jobs in New York, NY
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