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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.
$100,000 - $110,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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2) + years of high-volume recruitment experience of clinical and para-professional positions in Home Care, specifically LHCSA/CHHA/MLTC required. 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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NYC Health + Hospitals is the largest public health care system in the United States. At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception.
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Job Summary: The VP, House Calls is accountable for the day-to-day performance of all the clinical divisions (the primary, specialty, urgent care centers, nursing home, house calls) and support division (care management and managed service organization.
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The Clinical Reimbursement Specialist is also responsible for regulatory compliance and quality improvement efforts in order to attain appropriate Medicare or Managed Care reimbursement.
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Develop and maintain positive relationships with referents and other collateral contacts (i.e., Probation, Parole, CPS, managed care, E.A.P.’s, courts, etc.) Manages all aspects of assigned caseload during treatment, with special attention to appropriate levels of care and appropriate clinical interventions.
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Through coordination with the medical team, ensures clinical practice compliance with Managed Care/HMO, JCAHO, and Federal and State guidelines. The Family Practice FNP provides high quality medical care to adult & pediatric patients on a scheduled and unscheduled basis, consistent with accepted standards of clinical practice, including preventive activities such as screening examinations, comprehensive health assessments, diagnosis and treatment of minor, acute and chronic medical conditions.
$135,000 - $140,000 a yearExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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2 -3 years of Utilization Review experience at a Managed Care Organization is preferred. Minimum of 3-5 years experience in a hospital or home care clinical setting. The Senior Director of Clinical Review will monitor the Clinical Review Nurse's activities and outcomes, ensuring compliance with established regulatory and contractual requirements.
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Job Responsibilities: Develops and implements Standards of Practice for the Clinical Denials and Appeals Specialists as it relates to formulating and submitting responses to Clinical Denials from commercial payors, Managed Care and Third Party Review Organizations.
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Under the supervision of the Director of Healthcare Revenue Cycle Management, the Credentialing Specialist’s overall responsibility is to ensure that the clinical staff maintains current credentials that enable them to work legally and performs all tasks necessary to ensure timely, accurate and reliable processing of healthcare staff appointments, reappointments, managed care enrollment, delegated credentialing, re-credentialing and managed care audits.
$60,000Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Our practice is proud to offer a wide spectrum of services, including Hematology/Medical Oncology, Breast Surgical Oncology, Palliative Care, Radiation Oncology, as well as Clinical Trials & Research Programs.
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Working knowledge of Medicaid/Medicare, D-SNP, MAP, and Managed Long Term Care (MLTC) product lines Valid driver's license and the ability to travel throughout the tri-state area to a variety of community and clinical settings.
$70,000 - $80,000 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Current with the Continuing Medical Education (“CME”) licensure requirementsCurrent, relevant, and substantial knowledge of areas related to health center licensing and operations, e.g., legal/regulatory, administrative, policy, protocols, and other clinical issues, especially within a managed care environment, required.
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The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health, etc.) Job Description SummaryThe Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers.
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Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies. Duties: Coordinates utilization review s of managed care contracts using established guidelines and processes.
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managed care clinical jobs in New York, NY
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