Managed Care Jobs in Bronx
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Search Results - Managed Care Jobs in Bronx
Bronxicims.com
relationship to the Chief Administrative Officer. The Director serves as the administrative bridge between behavioral health, primary care, and external stakeholders — including state agencies, managed care organizations, and community partners...
Molina HealthcareBronx
engagement, and developing integrated care plans that address both medical and behavioral health needs. Case management and managed care experience is preferred.
Essential Job Duties
• Completes comprehensive behavioral health assessments of members per...
Bronxvnshealth.org
applications required
Prior experience working in an integrated setting preferred, and experience in providing trauma-informed care preferred
Experience with EMR systems preferred Knowledge of city and state agency and/or managed care functioning preferred...
MCKESSONBronx
and development of McKesson products and services leveraging the experience of our pharmacy partners.
• Provide customers with marketing advice, financial analysis to formulate financial plans, managed care information, competitive data and profit enhancing...
Bronxicims.com
program goals.
Quality and Regulatory Compliance
• Ensure compliance with applicable federal, state, and local requirements, including New York State Medicaid managed care and Care Management regulations.
• Partner with Compliance, Legal, and Clinical...
Calvary HospitalBronxworkable.com
to facilitate eligibility review, including physician certification and verbal hospice orders; escalate clinical questions to RN as appropriate
• Verify insurance coverage and benefits (Medicare, Medicaid, managed care, commercial plans), determine authorization...
Bronxicims.com
registration billing information of patients, and obtains managed care insurance referrals. Schedules patient appointments, manages provider clinic schedule, reschedules missed appointments and maintain patient demographics.
Responsibilities:
• Establish...
Bronxicims.com
in supervising medical staff
• In-depth knowledge of Nursing & Rehabilitation centers and medical best practices
• Familiarity with managed care principles
• Ability to adhere to regulatory standards and quality measures
Salary: $250,000-$275,000
Equal...
Bronxicims.com
physician group, managed care organization, health plan, or payer environment.
• Strong knowledge of CMS regulations, Medicare Advantage, New York State Medicaid, HIPAA, and other applicable healthcare regulations.
• Demonstrated experience supporting...
Bronxicims.com
and Managed Care guidelines
Knowledge of medical terminology
Must be detailed oriented
Excellent verbal and written communication skills
Bilingual (English & Spanish) preferred
Excellent Customer Services and organizational skills...
Bronxicims.com
Medicare, Essential Plan, QHPs, managed care, and health insurance processes.
Familiarity with MAGI vs. non-MAGI eligibility, Medicaid spenddown, and APTC reconciliation.
Comfortable being on the phone throughout the day with high outreach and follow-up...
Bronxicims.com
Adaptable and comfortable working both in the field and in-office
Preferred Experience
• Experience working with Medicaid and managed care experience
• Familiarity with Social Determinants of Health (SDOH) and Social Care Network (SCN) programs...
Bronxicims.com
experience, with 3+ years in a senior leadership role.
• Healthcare experience required — managed care, value-based care, care management, or physician-facing services strongly preferred.
• Proven ability to build and manage a brand across multiple...
Bronxicims.com
Outlook, Word, and PowerPoint
Preferred Experience
• Experience with 1115 Waiver programs, Social Care Networks, Medicaid, or managed care compliance strongly preferred
• Experience supporting internal or external audits in a healthcare...
Bronxicims.com
solving mindset with attention to detail
Preferred Experience
• Experience with Medicaid, managed care, or 1115 Waiver programs
• Familiarity with Social Care Network (SCN) programs, HRSN screening, or Medicaid enrollment and recertification...
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