Medicare compliance jobs in Hoboken, New Jersey - Page 2Create job alerts

Job Description Position Objective: • Assists with staff development needs of employees and facilitate the educational programs to meet those needs., • Facilitates the provision of a company-wide orientation program to encompass all levels of staff., • Assists Director of Nursing with compliance review., • Assists in the provision of a standardized orientation of all employees within the designated branch offices. This orientation is related to the clinical practices of all levels of care. Facilitates the provision of all educational material to be presented to the employee at orientation or in the field., • Provides training to professional and paraprofessional staff in skills and competency evaluations., • Participates, as assigned, in teaching and training of other healthcare staff members including, but not limited to:, • Orientation of staff member(s) to an individualized plan of care, inclusive to have expected goals and outcomes., • Providing direction, especially as related to paraprofessional personnel in the ongoing implementation of the plan of care., • Providing ongoing education to the paraprofessional staff in the accurate and timely completion of all activity sheets, • Assists with the classroom teaching requirements for the HHA/PCA training curriculum insuring a comprehensive educational experience for students and high ratio of graduates., • Assists with the testing and grading procedures for all HHA/PCA candidates., • Under the direction of the Director of Professional Standards, based on the needs projected by the Branch and the Director of Nursing, assists with pre/post employment skills and assessment activities., • Participates in agency’s Quality Assessment and Performance Improvement Program (QAPI) and assures participation of all appropriate staff. Provides information that enables the collection and root cause analysis of data to identify opportunities for improvement., • Facilitates communication regarding the Agency’s philosophy, Joint Commission company standards, regulations, policies and procedures to the paraprofessional employees., • The candidate for this position must be a Registered Nurse, preferably bachelor’s, prepared with licensure in New York State and acute or homecare experience with the last two years., • All acceptable candidates must have a minimum of three years of clinical experience in their area of specialty., • Two years of their work must be in supervision/administration, preferably in a community health or home health setting. Basic knowledge of governmental home agency regulations, Medicare/Medicaid (as required) regulations, and Company policies are required., • Good organization, communication, human relation skills, and reliable transportation are required.

Job Description RN Health Care Facility Surveyor - All States (#1131) • Employee retirement plan (401k) with a generous match and immediate vesting, • Company-issued and company-paid Amex card for travel, • All travel expenses paid directly by the company, • Company-paid tax-free Health Savings Account (HSA) Responsibilities of the RN Health Care Facility Surveyor: The position is 100% remote with up to 75% travel. The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Surveyors travel to healthcare facilities nationally conducting surveys to assess compliance with requirements and regulations guiding the quality of care for residents/customers of the facilities. The responsibility of the Surveyor is to apply approved survey protocols for conducting on-site surveys. Specific activities include the following: • Conduct on-site surveys of Medicare-Medicaid certified health care facilities to determine compliance with Federal regulations., • Surveys require preparations such as off-site preparation, tour of the facility, observation of care, record review, interviews of staff and families, etc. Determine if care, treatment, and services are consistent with Federal requirements., • Evaluate many aspects of the healthcare facility system from the quality of care to the consumers’ rights and physical plant., • Communicate the non-compliance issues with key personnel throughout the site review and during the exit conference to assure an understanding of the deficiencies cited., • Determine if a plan of correction is acceptable., • Conduct follow-up visits and monitoring surveys to ascertain if facilities’ plans of correction to resolve the deficient practice have been implemented., • Training: Assist with facility and bureau training. Participate in work groups as needed Requirements • Must have an Associate or Bachelor’s degree in nursing, • Must have successfully completed CMS’s Long-Term Care Basic Training and passed the Surveyor Minimum Qualifications Test (SMQT)., • Must have At least two (2) years of recent experience working as a surveyor accrediting or certifying facilities that serve the residents of long-term care facilities., • Must maintain current licensure to practice as a Registered Nurse (RN)., • Demonstrated a history of independent decision-making skills to direct and effectively manage the survey process., • Ability to set priorities independently and collectively in performing survey tasks., • Ability to openly discuss conflicts/controversy, and to seek assistance when appropriate to make decisions and resolve conflicts., • The salary for this position is $75,000 - 90,000 / yr, • This is a Full-time position (Monday - Friday), • Flexible paid vacation days, • Paid holidays, • Company-issued and company-paid Amex card for travel, • All travel expenses paid directly by the company, • Airline and hotel points accumulate for employee's personal use, • Employee discounts, • Employee retirement plan (401k) with a generous match and immediate vesting, • Company-paid tax-free Health Savings Account (HSA), • Health insurance, • Dental insurance, • Vision insurance, • Company-paid life insurance, • Company-paid disability insurance, • Extensive training opportunity, • Predictable work schedule

Job Description The ICL PROS (Personalized Recovery Oriented Services) Program offers rehabilitation, counseling, therapeutic activities, and peer support each day to individuals living with severe mental illness. The Associate program director is a professional and administrative position with responsibilities for planning, developing, evaluating, and administering services as defined by the NYS Office of Mental Health for a PROS program. The mission of the PROS Program is to provide a safe, supportive, and therapeutic environment where an individual with mental illness can explore, identify, and strive to achieve recovery from the disabling effects of their mental illness. ESSENTIAL JOB FUNCTIONS: List all essential job duties. (To perform this job successfully, an individual must be able to perform each essential duty listed satisfactorily with or without a reasonable accommodation. Reasonable accommodations may be made to enable qualified individuals with a disability to perform the essential duties unless this causes undue hardship to the agency.) • Partners with the Program Director to lead and oversee all aspects of program operations, ensuring the delivery of high-quality clinical, recovery, and rehabilitative services for adults with mental health. Assist in managing program operations, including budget oversight and service delivery., • Supervise assigned clinical staff and conduct regular supervision meetings, • Provide direct services and crisis management to a limited caseload, conduct intakes, • Monitor case records and documentation to ensure compliance with internal and external standards., • Conduct psychosocial assessments and formulate treatment recommendations., • Coordinate referrals and ensure access to ancillary and support services., • Support preparation for audits and ensure adherence to OMH and other regulatory guidelines., • Assist in recruiting, training, and evaluating staff., • Maintain partnerships with community providers to support coordinated care., • Help manage billing systems and service hour documentation., • Prepare required reports and assume leadership in the Program Director’s absence., • Committed to equity, diversity, inclusion and belonging, and active promotion of the ICL values and goals., • Ability to master Electronic Health Record and all other software required to operate the program., • Ability to lead a multi-disciplinary staff of professionals and paraprofessionals in providing treatment services and ability to form and maintain effective teams., • Good knowledge of the policies and organization of the regulatory agency and applicable legislation, regulations, and rules., • Good knowledge of the principles and practices of supervision and leadership., • Basic knowledge of best practices, evidence-based treatment, and general treatment techniques., • Ability to form and maintain effective relationships with community and local and state government representatives., • Ability to assist in the preparation of written proposals for new or expanded treatment services., • Ability to identify from the record and from observation of deficiencies in individual treatment plans. Education: Licensed Psychologist or Licensed Clinical Social Worker with current, valid NYS registration Preferred, LMSW, LMHC required Continued employment is conditioned on the ability to maintain professional licensure, current registration and unrestricted participation in the Medicaid and Medicare programs Experience: Four years minimum postmaster’s clinical experience providing services to adults with serious mental illness and co-occurring substance use disorder. At least 2 years minimum progressive administrative and/or supervisory experience. Must have an excellent understanding of state and city OMH, and Medicaid regulations Preferred: Experience with PROS program is preferable though not required; trainings in Wellness Self-Management, Family Psychoeducation and Motivational Interviewing #ICLRN

Job DescriptionAbout CookUnity: Food has lost its soul to modern convenience. And with it, it has lost the power to nourish, inspire, and connect us. So in 2018, CookUnity was founded as the first-of-its-kind platform that connects the world with the source of truly great food: chefs. Today, CookUnity delivers 50 million meals a year from the industry's best chefs to homes all over the country. Fresh. Ready-to-eat. And crafted with the passion that nourishes body and soul. Unwilling to stop there, CookUnity is expanding beyond delivery to become an ever-innovating marketplace focused on our singular mission: empower Chefs to nourish the world. If that mission has you hungry in more ways than one, you've found the right job posting. The Role: We are scaling our B2B business to transform healthcare through Food as Medicine programs. As we expand, we are looking for a visionary General Manager of Strategic Healthcare Partnerships to lead our healthcare vertical, driving growth across payers, hospitals, and self-insured employers. As the healthcare vertical leader, you will own the strategy and execution of CookUnity's healthcare business. You will lead a team focused on developing partnerships with payers (Medicare, Medicaid, MCOs, ACOs), hospitals, and self-insured employers. You will design and execute a GTM strategy to grow revenue and position CookUnity as the leading provider of medically tailored meals. Key Responsibilities • Own P&L responsibility for the healthcare vertical with aggressive revenue growth targets., • Develop and execute GTM strategy for:, • Medicare payers (value-added benefits), • Medicaid programs (state-specific waivers and compliance), • Hospitals and provider partners (Hospital-at-Home, discharge meal programs), • Self-insured employers (chronic condition management and GLP-1 supportive meals), • Recruit, lead, and coach a team of high-performing AEs specialized in healthcare sub-segments., • Cultivate relationships with C-suite executives in payers, providers, and employers., • Navigate regulatory frameworks, including Medicaid waivers and Medicare Advantage supplemental benefits., • Build scalable processes and playbooks to support team growth., • Lead cross-functional collaboration with product, operations, and marketing to ensure alignment on offerings for the healthcare market including billing and customer support., • Define pricing and packaging strategies tailored to the healthcare ecosystem., • Act as the executive sponsor on strategic accounts, driving renewals and expansion., • Attend key industry events and healthcare conferences to build thought leadership and brand awareness., • Develop KPIs and reporting systems to track progress and make data-driven decisions., • Support creation and rollout of new MTM lines across different markets, • Work closely with the tech team and 3rd party providers to enable billing, and security compliance, • Lead strategic expansion in new states with Medicaid registration, contracting and partnershipsKey Requirements, • 10+ years of experience in healthcare, sales leadership, execution and strategy., • Proven track record of success selling into payers, hospital systems, and self-insured employers., • Deep understanding of healthcare regulations and reimbursement pathways (e.g., 1115 waivers, value-based care)., • Established network in the healthcare ecosystem (payers, providers, and brokers)., • Strong leadership skills with experience building and scaling teams. 🌅 401k Plan 📈 We grow, you grow: Stock Options Plan granted on Day 1 🌟 Eligible for a bi-annual performance bonus ⛱ Unlimited PTO 🗓️ 5- year Sabbatical: After 5 years with CookUnity, you get a 4-week paid sabbatical 🐣 Paid Family leave 🕯 Compassionate Leave: 3-5 days each time the need arises 🥘 A generous amount of CookUnity credits to enjoy our amazing meals, added to your account, monthly 🧘🏽️‍♀️ Wellness perks: access to fitness subsidies to build a healthy lifestyle 👩🏾️‍🏫 Personalized Spanish coach 🚀 Awesome opportunity to join a company that is looking to change how we eat and how chefs work! Compensation • Base Salary Range: $150,000 – $200,000 (depending on experience and network in the healthcare ecosystem), • On-Target Earnings (OTE): $300,000 – $350,000 (base + commission/bonus tied to revenue goals), • Incentives: Equity options and performance-based bonuses aligned with CookUnity's aggressive healthcare vertical growth targets.Why Join CookUnity?, • Be part of a mission-driven company transforming healthcare through food., • Build and lead a vertical that is critical to CookUnity's long-term success., • Competitive compensation package, including equity options. CookUnity is an Equal Opportunity Employer. We are dedicated to creating a community of inclusion and an environment free from discrimination or harassment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, citizenship status, protected veteran status, genetic information, or physical or mental disability. A quick note for all candidates We've recently seen an increase in recruitment scams across the industry, and we want to make sure you (and your data) stay safe while applying to CookUnity. We also want you to know that we take this seriously — sometimes, as part of our process, we may ask for a brief "proof of humanity" to confirm that we're connecting with a real person, not an impersonator. Here are a few tips to help you protect yourself and know what to expect from us: • Apply only through our official channels. All open roles are listed on our official careers page: careers.cookunity.com, • Our recruiters are real people — and easy to verify. You can always find them on LinkedIn with verified profiles. If you're unsure, feel free to reach out to us on our official LinkedIn Company Page., • We only communicate through official CookUnity channels. That means emails ending in @cookunity.com and interviews held through official company platforms (Google Meet or Zoom) — never WhatsApp, Telegram, or SMS.

Bachelor's degree in healthcare administration, business management, or a related field. Proven experience in project management within the healthcare industry, including successful project completion. Strong knowledge of healthcare regulations and compliance requirements, such as HIPAA, Medicare, a

A company is looking for an Accounts Receivable Representative to work remotely in a full-time, day shift role.Key Responsibilities Support billing and collections processes in a healthcare environment Handle insurance contracts and ensure compliance with Medicare/Medicaid regulations Assist in

Senior Contract Manager Analyst. The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. Senior Contract Manager Analyst.

Job DescriptionEmpower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlusHealth 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. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers. Position Overview Under the direction of the Director of Medicaid, the Medicaid Care Manager Team Lead ensures that staff adhere to the Medicaid contractual requirements, policies and procedures, and workflows established to manage the vulnerable Medicaid population. The Medicaid Care Manager Team Lead manages the daily activities of the Medicaid team (Care Managers and Care Management Associates) to ensure quality outcomes in the delivery of member-centered case management including reduction in emergency room visits and hospital admissions, improved member satisfaction, improved member health, and cost effectiveness. Work Shifts 9:00 A.M – 5:00 P.M Duties & Responsibilities • Provide clinical guidance and supervision to assigned Care Managers and clinical support staff to promote efficient and effective delivery of care management services, • Supervise day to day activities to make certain that case management services are provided in accordance with clinical guidelines, established processed and MetroPlusHealth organizational standards., • Supervise the entire care management workflow including case referrals, assignments, interventions and goal setting, follow-up/follow-through activities, documentations, and escalations., • Ensure care management activities are conducted in a safe, efficient, and effective manner to promote continuity and quality of care., • Review, develop and modify day to day workflows to ensure timely follow up., • Perform ongoing quality review of cases to ensure accuracy and compliance., • Evaluate and document staff performance; coach staff to improve both quality and quantity of skills attaining optimal performances., • Utilize data to track, trend and report productivity and outcome measures, work with the management team to implement necessary improvement strategies., • Coordinate Interdisciplinary Care Team rounds with providers, care managers and care management associates, this include scheduling meetings, identifying members for presentation, and ensuring completion and documentation of follow up activities., • Collaborate Behavioral Health to develop strategies and best practices that lead to desired goals and objectives for members who are co-managed., • Use expert verbal and non-verbal communication skills to motivate and gain co-operation of members and their caregivers., • Resolve issues and mitigate conflict encountered during daily operations, appropriately escalate issues to the Director of Medicaid, • Identify and report potential risk, operational opportunities, and barriers encountered., • Conduct monthly audits for the purpose of departmental/organizational reporting and providing formal feedback to case management staff., • Create and submit operational weekly/monthly/quarterly reports., • Work with the leadership team to develop and implement ongoing training and development efforts., • Actively participate in staff training and meetings., • Encourage regular communication and inform staff of relevant departmental and organizational updates., • Develop and maintain collaborative relationships with clinical providers, facility staff and community resources., • Ensure staff comply with orientation requirements, annual and other mandatory trainings, organizational and departmental policies, and procedures., • Perform other duties as assigned by Director.Minimum Qualifications, • Bachelor's Degree required, Master’s in nursing preferred., • A minimum of 5 years of Care Management experience in a health care and/or Managed Care setting required., • Minimum of 2 years managerial/leadership experience in a Managed Care and/or healthcare setting required., • Proficiency with computers navigating in multiple systems and web-based applications., • Must know how to use Microsoft Office applications including Word, Excel, and PowerPoint and Outlook., • Ability to proficiently read and interpret medical records, claims data, pharmacy and lab reports, and prescriptions required, • Valid New York State license and current registration to practice as a Registered Professional Nurse (RN) Issued by the New York State Education Department (NYSED)., • Integrity and Trust, • Customer Focus, • Functional/Technical Skills, • Confident, autonomous, solution driven, detail oriented, nonjudgmental, diplomatic, resourceful, intuitive, dedicated, resilient and proactive., • Strong verbal and written communication skills including motivational coaching, influencing, and negotiation abilities., • Holds themselves to high standards of excellence, • Time management and organizational skills., • Strong problem-solving skills., • Ability to prioritize and manage changing priorities under pressure., • Ability to work closely with member and caregiver., • Ability to form effective working relationships with a wide range of individuals. #MPH50 #LI-Hybrid Benefits NYC Health and Hospitals offers a competitive benefits package that includes: • Comprehensive Health Benefits for employees hired to work 20+ hrs. per week, • Retirement Savings and Pension Plans, • Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts, • Loan Forgiveness Programs for eligible employees, • College tuition discounts and professional development opportunities, • College Savings Program, • Union Benefits for eligible titles, • Multiple employee discounts programs, • Commuter Benefits Programs

Job DescriptionHealthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Responsibilities will Include:- Review, sort, and analyze data using computer software programs such as Microsoft Excel.- Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.).- Develop HCF case referrals including, but not limited to:- Ensure that HCF referrals meet agency and USAO standards for litigation.- Analyze data for evidence of fraud, waste and abuse.- Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence.- Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings.- Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc. - Assist conducting witness interviews and preparing written summaries. Qualifications:- Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field.- Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work.- Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc.- Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data).- Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy.- U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.- Experience and expertise in performing the requisite services in Section 3.- Must be a US Citizen.- Must be able to obtain a favorably adjudicated Public Trust Clearance.Preferred qualifications:- Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3.- Relevant experience working with a federal or state legal or law enforcement entity. #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job DescriptionDescription: Position Summary: The RT Vent Field Clinician is a Respiratory Therapist providing respiratory patient care to Vent patients for optimal outcomes. Provides respiratory care to patients in alternate sites in accordance with AdaptHealth’s policies and procedures. Respiratory care will be preventative, rehabilitative, and palliative in nature. The RT will utilize all the resources available within the agency and community to accomplish care objectives. This position will provide education and care to the patient and communicate with team, physicians and referral sources and other patient agencies ensuring prompt attention to patient care issues. Essential Functions and Job Responsibilities: • Utilizes various sources of information to attain greater competence about his or her position, including attending educational events (including attending optional in-services) and asking questions., • Utilizes acquired knowledge to increase his or her competencies., • Consistently demonstrates ability to adequately complete all documentation and charting procedures in compliance with company policy and procedures., • Maintains complete and accurate patient files by updating all documents per company policy and procedures., • Reviews Plan of Treatments and Care Plans to assure they are accurate and up to date., • Documents procedures including how the patient tolerated a procedure, side effects and other pertinent information., • Assists with authorization for Ventilator referrals for patients., • Shows adequate knowledge of respiratory equipment and displays ability to utilize knowledge in the clinical setting., • Displays knowledge of assessment skills and demonstrates application of clinical skills during set-ups, follow-ups, and in-services., • Participates in discharge planning of highly technical cases., • Performs clinical assessments as needed and reports results and recommendations to the referral and physician., • Participates in highly technical discharges and prepares in advance to assure the patient and caregivers have a smooth transition to the home setting., • Performs in-services to hospital staff, referrals, other professionals regarding equipment & issues of clinical nature., • Follows up with physician and referrals regarding patient status and documents accurately and in a timely manner., • Retain knowledge of and consistently adhere to procedures for the use of Personal Protective Equipment (PPE), infection control and hazardous materials handling., • Works to promote AdaptHealth by new program development, operational backup, personal visits, coordination of educational activities, etc., • Assume on-call responsibilities during non-business hours in accordance with company policy., • Uses clinical expertise in evaluating vent patients records once a ventilator set up has been completed by the branch Respiratory Therapist., • Ensures accuracy of prescriptions and plan of care was followed and documented. Also reviews delivery tickets, home inspection, ventilator check, and patient equipment competencies are complete and documented., • Maintains proficient knowledge of ventilator patients including compliance software, new technology, units, and supplies supported by Adapthealth., • Ability to demonstrate and instruct on use of vent units and supplies. Ability to make decisions for patients based on compliance data and assessment., • Communicates with team, physicians and referral sources and other patient agencies ensuring prompt attention to patient care issues., • Maintains working knowledge of Medicare/Medicaid and other third-party payer guidelines related to ventilation., • Electronically documents patient care activity, intervention provided and all communication regarding the patient. Documentation is accurate, complete and follows company standards., • Appropriate steps taken to ensure recommendations and orders sent are acknowledged and followed up in a timely manner., • Responsible for accuracy, clarity, and timeliness of verbal and written communications as it relates to role., • Responsible for documentation that supports data collection to track and trend outcomes., • Assists in establishing clinical documentation when needed for third party reimbursement or justification., • Uses knowledge in working with referral sources to educate about best practice standards., • Works collaboratively and pro-actively with peers and other team members to resolve issues and assure optimum outcomes for patients, referral sources and staff., • Acts as a resource on practices and processes to provide appropriate guidance., • Develop and maintain working knowledge of current HME products and services offered by the company., • Maintain patient confidentiality and function within the guidelines of HIPAA., • Completes assigned compliance training and other educational programs as required., • Maintains compliant with AdaptHealth’s Compliance Program., • Experience with ventilator patients, • Competent in Ventilator, Airway Clearance, and Oxygen therapy administration and management, • Able to perform clinical assessments., • Equipment troubleshooting and maintenance skills., • Decision making skills., • Expert communication and interpersonal skills, • Ability to prioritize tasks and manage multiple projects., • Strong analytical and problem-solving skills with attention to detail, • Proficient use of Microsoft Office Suite – Excel, Word, and PowerPoint, • Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction., • Knowledge of the regulatory requirements at the state, federal, and local level, • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form., • Associates degree from an AMA approved respiratory program,, • Valid and unrestricted RT clinical license in all states serviced by the branch., • Must be CPR certified,, • One (1) year of clinical experience as a Health Care RT, HME RT or clinical nursing with Vent experience., • Must be able to lift 50 pounds, stand, bend, stoop, and be able to sit at a computer for extended periods of time., • Must be able to perform one-man CPR., • Ability to perform repetitive movements of the upper extremities’ motions of wrists, hands, and/or fingers due to extensive computer use., • May be exposed to unsanitary conditions in some home settings., • Work environment may be stressful at times, as overall office activities and work levels fluctuate., • May be exposed to high crime areas within the service community., • Subject to long periods of sitting and exposure to computer screen., • May be exposed to hazardous materials, loud noise, extreme heat/cold, direct, or indirect contact with airborne, bloodborne, and/or other potentially infectious pathogen., • May be exposed to angry or irate customers or patients., • Must be able to drive and travel as needed., • Physical and mental ability to provide clinical assessments., • Requires travel throughout service area., • Mental ability to communicate both verbally and in writing., • Must be able to access the patient’s residence., • Ability to work outside of normal business hours., • Physical and mental ability to provide clinical assessments. PIb9511ddbd043-25405-38421302

Job Description RN-Director of MDS Full Time Cobble Hill Health Center is a not-for-profit long- and short-term care facility providing services to the disabled and elderly for over 40 years. The MDS Assessor will play an integral role in helping us to achieve our vision: to consistently exceed expectations and set the standard for excellence in residential and community care. We are seeking an experienced and detail-oriented Director of MDS to lead and oversee all aspects of the MDS process, ensuring compliance, accuracy, and optimal reimbursement. This role is responsible for monitoring CMI, leading related meetings, and regularly communicating Quality Measures to the interdisciplinary team. The Director will review MDS assessments to ensure accurate coding, conduct PDPM reviews upon admission and prior to submission, and collaborate with rehab to verify correct primary diagnoses. Responsibilities also include reviewing UB04s, managing ADR responses and appeals, coordinating with Livanta, and submitting timely documentation to the billing company. The Director will also play a key role in audit responses, run Medicare Part B reports, and actively participate in key facility meetings including Medical Board, Therapy, QAPI, and Utilization Review. This role is essential in ensuring and maximizing proper reimbursement will maintaining compliance with federal and state guidelines. This is a key clinical position in a renowned health care facility among innovative and committed leaders in the industry. Excellent professional environment providing an opportunity to learn, grow and have an impact on the overall results. What we offer: • Referral bonuses, • An opportunity to express your talents and lead a high-performing team, • Free hot meal for each shift worked, • Retirement plan with employer contribution, plus a 403b, • Generous medical, dental, vision, and life insurance coverage, • Employer contribution toward medical deductible This position requires a current New York State RN license and three or more years of experience in a long-term care facility as an MDS Coordinator, along with knowledge of Medicare and Medicaid criteria and assessment regulations. The ideal candidate must possess excellent listening and communication skills, the ability to complete documentation in a timely manner, as well as attention to detail and accuracy when performing assessments. RAC Certification, as well as prior leadership experience strongly preferred. Job Posted by ApplicantPro

Job DescriptionDescription: The primary function of the HEDIS Retriever - Seasonal is to conduct onsite abstraction of services from medical charts in compliance with HEDIS/QARR, Medicare Advantage Star measure specifications. This position will be an integral part of the annual Medical Record Review project required to report HEDIS and QARR measures to the NYS Department of Health and Centers for Medicare & Medicaid Services (CMS). The position requires the ability to travel within the five boroughs daily. Scope Of Role and Responsibilities: • Maintain knoowledge of medical record review and EMR systems, • Maintain up to date knowledge of HEDIS, QARR and STAR specifications., • Proficiency in MS Office applications, scanning and accurate Data entry into our systems, • Distibute requests for records and schedules appointments with provideroffices to ensure timely completion of duties to meet internaland regulatory standards and requirements., • Perform abstractions via EMR, in house paper medical records, on- site provider visits to collectdocumentationof easure complaince., • High School/GED with a minimum of two yeards HEDIS review experience. Clinical background preferred ( Medical Assistant, Nursing Assistant, Health Educator, LPN, RN, LMSW, or LCSW), • Experience with medical record working on HEDIS/QARR in a managed care, health plan and provider office setting., • Proficient in Microsoft Office applications including Work, Excel, PowerPoint and Access.

Job Description Billing Manager for our Skilled Nursing Facility ( SNF ) Compensation: $125,000 - $180,000 Annual Salary Benefits: Medical, dental, vision, life insurance, long-term and short-term disability insurance and 401K with a match program. PTO. Job Type: Full time, in person position Are you passionate about making a difference in others' lives? We are looking for a Billing Manager for our Skilled Nursing Facility ( SNF ) who prides themselves on a positive attitude and dedication to providing top-notch care. We are offering COMPETITIVE PAY with AMAZING BENEFITS and great WORK LIFE BALANCE. If this is something you are looking for, we'd love to have you on board! Job Description: We are seeking a skilled and detail-oriented Billing Manager to lead our billing and collections operations. The ideal candidate will ensure accuracy, compliance, and efficiency across all processes, manage payer relationships, and guide a team to optimise revenue cycle performance and strengthen the organisation's financial health. Qualifications: • Degree in Accounting, Finance, or Healthcare preferred., • 5+ years billing experience in skilled nursing or long-term care., • Proficient in PointClickCare (PCC), EOBs, and payor portals., • Strong knowledge of Medicare, Medicaid, and Managed Care billing., • Multi-facility or team leadership experience preferred., • Excellent communication, analytical, and problem-solving skills. Responsibilities include but are not limited to: • Manage billing and collections for 14 SNF locations., • Ensure timely, accurate claim submissions for all payers., • Monitor aging reports and reduce outstanding A/R balances., • Verify census and payer updates in PointClickCare (PCC)., • Collaborate with finance and facility teams to resolve billing issues., • Analyse denials and implement corrective training or actions., • Ensure compliance with all billing regulations and procedures., • Prepare billing performance reports for leadership. #MISCHP

Job DescriptionAbout Pair Team Pair Team is a public benefit company reimagining care for the safety net. As an AI-enabled medical group for Medicaid and Medicare, we deliver medical, behavioral, and social care by integrating shelters, pantries and other community-based organizations into our whole-person model. As California's largest complex care provider, we've proven our impact to reduce avoidable emergency care, including a 52% and 26% reduction in ER visits and hospitalizations respectively. Once scaled nationally, our approach would save tax payers $150B per year. With our years of experience and vast data collected, we are now building an AI platform that embeds social work agents across the safety net to truly unify our fragmented healthcare and welfare system. By scaling our country's frontline medical and social services workforce, we aim to bring high-touch care to everyone. At Pair Team, we're not just delivering care—we're transforming it. We're building a future where high-touch, community-driven care is accessible to everyone, especially the most underserved. • Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most, • TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team As a VP of Finance you'll report to the Chief Operating Officer. What You'll Do • Oversee financial performance across multiple business lines, building scalable, data-driven models to forecast revenue, manage margins, measure ROI of new initiatives, and optimize capital allocation., • Serve as a key thought partner to the executive team on financial strategy, growth planning, and risk management., • Lead financial management of value-based care contracts, including forecasting capitation and shared-savings revenue, modeling risk-adjusted performance, managing cash flow and reserves across payor settlements, and aligning care delivery costs with quality and utilization outcomes., • Oversee all accounting, audit, and tax functions, ensuring GAAP compliance, timely monthly closes, and effective collaboration with external advisors to optimize entity structure, filings, and audit readiness., • Build and scale a high-performing finance organization by recruiting and mentoring a best-in-class team., • Establish internal controls, policies, and systems to ensure data accuracy, integrity, and compliance., • Build scalable systems for revenue recognition, claims, billing, accounts receivable/payable, and cash flow management., • Manage insurance, risk, and financial compliance related to healthcare regulations and value-based care contracts., • Lead fundraising and investor relations, including managing financial due diligence, supporting capital raise processes, preparing board and investor materials, and communicating company performance, forecasts, and strategic plans to current and prospective investors., • Support the executive team with cap table management.What You'll Need, • 10+ years experience in FP&A, strategic finance, and accounting, with at least 3 years of experience in digital health, • 5+ years of leadership experience building and scaling high-performing finance teams and overseeing strategic financial operations, • Deep experience supporting value-based care payment models, • Strong understanding of corporate practice of medicine (CPOM) compliance and MSO–PC structuring, • Experience working with accounting and ERP tools, • Strong ability to translate financial insights into operational levers and strategic decisions across functions, • Comfort working in a fast-paced, startup environment with cross-functional collaboration and proven ability to instill financial discipline in a rapidly scaling environment, • Strong judgment and business acumen with an ability to balance financial risk and strategic opportunity, • Ability to communicate financial strategy and insights clearly to executive teams, boards, and investors, • A passion for healthcare access and a commitment to serving underserved populations, • Experience with data visualization tools, i.e. Looker, Tableau, and working closely with operational stakeholders are both strongly preferred Because We Value You • Competitive salary: $225,000 - 250,000, • Equity compensation package, • Flexible vacation policy – take the time you need to recharge, • Comprehensive medical, dental, and vision coverage, • 401(k), • 100% company-sponsored short and long-term disability and life insurance, • Subsidized backup childcare and caregiver supports through Wellthy, • Work entirely from the comfort of your own home, • Monthly $100 work from home expense stipend, • We provide the equipment needed for the role, • Opportunity for rapid career progression with plenty of room for personal growth!, • Travel reimbursements for any company retreats or leadership offsites Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law. Pair Team participates in E-Verify to verify employment eligibility for new hires. Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use. We do not conduct any TA business outside of our @pairteam.com emails. If you're ever concerned about spam or fraudulent activity, please reach out to . Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!

Job Description Provides appropriate and clinically indicated services to children, adolescents, parents and families in an on-site school-based satellite clinic in addition providing support at HPC. Provides in-service training, collateral contact, and support to teachers and school personnel. Maintains clinical records within all Federal, State, and City regulations documenting all services provided. ESSENTIAL JOB FUNCTIONS: List all essential job duties. (To perform this job successfully, an individual must be able to perform each essential duty listed satisfactorily with or without a reasonable accommodation. Reasonable accommodations may be made to enable qualified individuals with a disability to perform the essential duties unless this causes undue hardship to the agency.) • Provides trauma- Informed, recovery-oriented, integrated, person-centered care to individuals with severe and persistent mental health diagnoses., • Utilizes clinical modalities such as CBT, MI, REBT, DBT and SFBT to support Clients, • Effectively and empathically provides direct clinical services including individual, family, and crisis intervention as clinically indicated., • Conduct intakes in schools and HPC as needed; hold a caseload of 50+, • Collaborates with an interdisciplinary team and consults with supervisor as clinically indicated., • Maintains clinical records in compliance with all City, State, and Federal regulations as per the State Office of Mental Health, and the State of New York Department of Health., • Complies with managed care requirements including consulting with care coordinators, obtaining treatment authorization, and providing necessary documentation in a thorough and timely manner., • Committed to equity, anti-racism and active promotion of the ICL equity goals and action steps., • Strong clinical writing skills; ability to accurately document counseling sessions demonstrating an understanding of mental health status, recovery-oriented treatment planning and psychiatric and substance harm reduction techniques, • Computer proficiency. Ability to master electronic health record software, use word processing programs, and computer programs and applications to provide telehealth as required, • Cultural competency is essential., • Ability to work effectively in high pressure mental health crisis environment, • Ability to maintain composure and demonstrate trauma -informed Person-Centered care to clients in a crisis Ability to meet deadlines., • Ability to follow procedures and instructions; prioritize, think logically and advocate professionally., • Demonstrates knowledge of, and supports, clinic mission, vision, and values, standards, and the code of ethical behavior. Education: LMSW, LMHC or LCSW; current, valid registration certificate. Must be eligible for full and unconditional participation in the Medicaid and Medicare programs Experience with children and families and/or a school-based setting is preferred but not required

Job DescriptionAthenaPsych is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges. We specialize in individual and group psychotherapy for clients with a focus on trauma-informed care. We are dedicated to improving the quality and accessibility of mental health care for all, especially individuals from underserved communities. Here at AthenaPsych, we pride ourselves on hiring a diverse group of mental health clinicians and staff who are passionate and dedicated to improving our client’s overall emotional well-being. We provide both in-person and telehealth services for our clients and offer a competitive fee-for-service compensation plan and amazing benefits to our staff. Are You a Good Fit For Us?We are currently seeking an experienced, professional, and compassionate Psychiatric Nurse Practitioner to join our growing organization. Flexible hours are provided with the need of some evening hours, in-person and telehealth sessions. This position will work in collaboration with our Psychiatrist on staff. Our mental health clinic is located at 33 W 60th St 6th floor New York, NY.Responsibilities • Conduct psychiatric evaluations for all Athena clients (children and adults), • Conduct ongoing medication management when needed, • Complete all required documentation by a given deadline and in compliance with program and state regulations, • Ensures all clinical notes and client information are updated and accurate within the current EHR system, • Provide conflict resolution and crisis intervention when needed, • Work in collaboration with administrative staff to ensure client needs are successfully met, • Ability to commute between sites when neededQualifications, • Master's Degree in Nursing from an accredited school, • Bilingual in English and Spanish prefered, • Must be certified with the Drug Enforcement Administration in order to prescribe medication to clients, • Must be licensed in New York State, • Experience working with Medicaid/Medicare Clients is a plus

Job DescriptionAthenaPsych is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges. We specialize in individual and group psychotherapy for clients with a focus on trauma-informed care. We are dedicated to improving the quality and accessibility of mental health care for all, especially individuals from underserved communities. Here at AthenaPsych, we pride ourselves on hiring a diverse group of mental health clinicians and staff who are passionate and dedicated to improving our client’s overall emotional well-being. We provide both in-person and telehealth services for our clients and offer a competitive fee-for-service compensation plan and amazing benefits to our staff. Are You a Good Fit For Us?We are currently seeking an experienced, professional, and compassionate Psychiatric Nurse Practitioner to join our growing organization. Flexible hours are provided with the need of some evening hours, in-person and telehealth sessions. This position will work in collaboration with our Psychiatrist on staff. Our mental health clinic is located at 33 W 60th St 6th floor New York, NY.Responsibilities • Conduct psychiatric evaluations for all Athena clients (children and adults), • Conduct ongoing medication management when needed, • Complete all required documentation by a given deadline and in compliance with program and state regulations, • Ensures all clinical notes and client information are updated and accurate within the current EHR system, • Provide conflict resolution and crisis intervention when needed, • Work in collaboration with administrative staff to ensure client needs are successfully met, • Ability to commute between sites when neededQualifications, • Master's Degree in Nursing from an accredited school, • Bilingual in English and Spanish prefered, • Must be certified with the Drug Enforcement Administration in order to prescribe medication to clients, • Must be licensed in New York State, • Experience working with Medicaid/Medicare Clients is a plus

Job Description Join VillageCare as a Full-Time HealthCare Claims Analyst and take your career to the next level while working from the comfort of your home. With a competitive salary range of $58,039.46 to $65,294.40, this position offers great financial incentives while allowing you to maintain a flexible work-life balance through hybrid schedule. At VillageCare in New York, NY, you will have the opportunity to contribute to a forward-thinking organization that emphasizes customer-centric solutions and excellence in healthcare. You will be part of an energetic team that values problem-solving and integrity, empowering you to drive meaningful change in the industry. You will be given great benefits such as Medical, Dental, Vision, Life Insurance, Health Savings Account, Competitive Salary, and Paid Time Off. This role not only enhances your professional skills but also places you at the heart of a mission-driven environment focused on making a positive impact in healthcare. Apply today to be part of our dynamic team! A little about us VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. Are you excited about this HealthCare Claims Analyst job? The Full-Time HealthCare Claims Analyst position at VillageCare requires a seasoned professional with a minimum of five years of experience in healthcare claims reporting and processing, alongside in-depth knowledge of Medicaid and Medicare guidelines. The ideal candidate should possess advanced SQL coding and Excel skills to create insightful reports and dashboards. You will play a critical role in understanding healthcare reimbursement from both financial and operational perspectives, conducting audits, and performing root cause analysis to resolve identified issues with internal teams and third-party administrators (TPAs). This position involves identifying gaps in various aspects of claims processing, communicating trends and contract issues to management, and preparing comprehensive narratives and visual aids for leadership presentations. You will also coordinate workflows across departments, ensure compliance with regulations, and contribute to the development of policies and quality assurance measures. Your analytical skills will be essential in evaluating claims system coding to validate pricing and improve overall operational efficiency. Would you be a great HealthCare Claims Analyst? To excel as a Full-Time HealthCare Claims Analyst at VillageCare, candidates must possess a Bachelor's Degree in a relevant field such as Computer Science, Mathematics, Statistics, or Engineering, with a Master's degree preferred. A minimum of 3-5 years of experience in business intelligence and analytics is crucial, particularly in a healthcare environment where complex data analysis and report/dashboard development are key responsibilities. Familiarity with medical terminology and coding systems, including ICD-10, CPT, HCPCS, along with knowledge of CMS guidelines and EncoderPro, is essential. The analyst should demonstrate excellent technical proficiency in tools such as MS Excel, SQL, Tableau, and Access. Strong communication skills, both written and verbal, are imperative for effectively conveying analytical findings and collaborating with various departments. The ability to work independently while maintaining a high level of productivity will significantly contribute to success in this role. Knowledge and skills required for the position are: • Education: Bachelor's Degree required ideally in a relevant field such as Computer Science, Mathematics, Minimum Statistics and/or Engineering. Master's degree preferred., • This position requires a minimum of 3-5 years' experience in business intelligence and analytics performing increasingly complex data analysis and report/dashboard development preferably in a healthcare setting., • Knowledge of medical terminology, ICD-10, CPT, HCPCS coding CMS guidelines and EncoderPro are required., • Must be able to work independently with high level of productivity and advanced written and verbal communication skills., • Excellent technical skills (MS Excel, SQL, Tableau, Access, etc.) · Strong communication skills. MUST RESIDE IN NY, NY OR CT Will you join our team? If you believe that this position matches your requirements, applying for it is a breeze. Best of luck! Job Posted by ApplicantPro

Job DescriptionSalary: $20-$25 per hour Job Description: Overview We are seeking an experienced Laboratory Biller to join our team. The ideal candidate has strong knowledge of laboratory billing, CPT/HCPCS codes, ICD-10 coding, and payer-specific billing guidelines. This role is responsible for accurate claim submission, payment posting, resolving denials, and ensuring timely reimbursement for laboratory services. Responsibilities • Prepare and submit laboratory claims to Medicare, Medicaid, and commercial payers., • Verify accuracy of CPT/HCPCS, ICD-10, and modifiers prior to claim submission., • Review requisitions, results, and documentation for billing compliance., • Work rejections and denials; correct and resubmit claims as needed., • Follow up on unpaid or underpaid claims to ensure timely reimbursement., • Post payments, adjustments, and reconcile accounts., • Communicate with labs, providers, and insurance companies regarding claim issues., • Maintain knowledge of payer policies, NCCI edits, LCD/NCD rules, and coverage criteria., • Ensure compliance with HIPAA and all billing regulations., • Minimum 13 years of laboratory billing or medical billing experience required., • Strong understanding of lab-related CPT codes (e.g., chemistry, toxicology, molecular, pathology)., • Experience with EHR/EMR and billing software (specify if needed)., • Knowledge of claim lifecycle, EOBs, ERA, and electronic claim submission., • Excellent attention to detail and problem-solving skills., • Strong communication and organizational abilities., • Health insurance,, • PTO, holidays,, • 401k,

Job Description Insurance Authorization Specialist - Must have experience - HYBRID 2 days a week in office midtown Pay: $19–$20/hr • Processed and reviewed healthcare authorizations with a focus on accuracy, timeliness, and compliance with Medicare and Medicaid (CMS) guidelines., • Demonstrated proficiency in Microsoft Office Suite, documentation, and scheduling., • Scheduled and coordinated healthcare services, prioritizing urgent requests while ensuring all authorization and review steps were completed correctly., • Adapted quickly to hybrid work environments, maintaining high productivity both remotely (with secure high-speed internet) and in-office. Schedules : Monday - Friday or Wednesday through Sunday 9 - 5 Resumes to Work Location: Hybrid remote in New York, NY 10011

Job Description Title Nurse Practitioner of Psychiatry Department Center for Resiliency and Wellness Reports To Chief Medical Officer Job Location 623 Broadway, 3rd Floor, NY, NY 10012 Job Status Independent Contractor (1099) Availability Monday-Friday; 8-24 hours remote and/or on-site per week within hours of 9am-7pm Approval Chief Health and Human Services Officer Requirements Psychiatric-Mental Health Nurse Practitioner License About Greenwich House Founded in 1902 as a settlement house to help New York’s increasing immigrant population adjust to life in a new country, Greenwich House today offers a variety of programs and approaches that continue to provide thousands of New Yorkers with health and wellness support, education, personal enrichment, skills building and cultural experiences. Position Summary The Nurse Practitioner of Psychiatry provides patient care for individuals seeking or in treatment for mental health within the Greenwich House Health Services Division. The Nurse Practitioner of Psychiatry works collaboratively with clinic MDs to provide patient assessment and diagnosis, formulate treatment plans, prescribe medications, order laboratory tests, interpret test results, provide patient education, prepare medical records, and refer patients for inpatient care in accordance with statutes, regulations and protocols regulating the profession. The Nurse Practitioner of Psychiatry works under the supervision of the Medical Director. Responsibilities • Comprehensive knowledge of mental health and substance use disorders to include dually diagnosed, and harm reduction., • Experience working with adults across age ranges to include ages 18 to 100+., • Ability to communicate and work as a team with Greenwich House HSD managerial and line staff., • Comprehensive understanding of regulations and compliance requirements for documentation., • Strong problem-solving and strategic-thinking skills, ethical decision-making and discretionary judgment., • Ability to lead, motivate, supervise, evaluate, train, and manage health professional students., • Respectful, collaborative, and energetic style., • Excellent organizational skills, including the ability to work under pressure., • Perform other duties and special assignments as directed by supervisor. Clinic Responsibilities • The NPP provides patient assessment, diagnosis, and treatment plans in accordance with statutes, regulations and protocols regulating the profession., • Collaborates with the staff physicians and advanced practice providers, the nursing staff, and technical personnel, as well as therapists, case managers, and outside providers to improve outcomes and care coordination., • Provides psychiatric health services, education, individual and group counseling and assessment, primarily onsite but through telehealth when indicated., • Refers patients for inpatient care, as necessary., • Issues medication prescriptions in accordance with treatment guidelines., • Administers injectable medications as clinically indicated., • Orders laboratory tests, interprets and explains the test results to patients., • Communicates with patients and engages in follow-up as necessary., • May also provide primary medical care services as indicated, in accordance with statutes, regulations and protocols regulating the profession. Compliance and Risk Management • Maintain credentials, Medicaid/Medicare and Managed Care enrollment., • Complete documentation within HSD standards., • Participate in incident management when applicable. Qualifications • Experience as a licensed practicing NPP, preferably in a community-based non-profit or other mission-driven organization that targets adult underserved populations., • New York State Certified Psychiatric-Mental Health Nurse Practitioner licensure required., • Cannot be disbarred, sanctioned, or excluded from Medicaid/Medicare services or being at a location where children are present., • Active DEA registration., • At the time of and throughout employment cannot be listed in any of the federal or state Medicaid/Medicare exclusion lists, and Statewide Central Registry for abuse and neglect., • Microsoft Suite literate, EHR competent and able to function in a technology driven environment. Reasonable Accommodations Statement To perform this job successfully, a successful candidate must be able to perform satisfactorily each essential duty. Reasonable accommodations may be made to enable qualified candidates with disabilities to perform these duties. Equal Employment Opportunity Greenwich House is strongly committed to the principle of equal employment opportunity for all individuals. All employment decisions and administration of all personnel policies are without regard to an applicant or employee’s actual or perceived race, religion, sex, age, national origin, creed, color, gender, sexual orientation or affectation, gender identity or expression (including transgender status), predisposing genetic characteristic, genetic information, pregnancy, ancestry, ethnicity, citizenship, alienage, military or veteran’s status, physical or mental disability, status as a victim of domestic violence, stalking offense and sex offenses, marital status, partnership status or any other status protected by federal, state or local law. For more information regarding Greenwich House and our EEO statement, please visit

Requirements · Bachelor's degree in Finance, Accounting, or related field · MBA/CPA strongly preferred · 10+ years of progressive financial leadership experience · Deep understanding of government grants, Medicaid/Medicare billing, and nonprofit compliance (OMH, OASAS)

Evaluate many aspects of the healthcare facility system from the quality of care to the consumers’ rights and physical plant. Conduct on-site surveys of Medicare-Medicaid certified health care facilities to determine compliance with Federal regulations. Surveyors travel to healthcare facilities na

M-F OR Option for 3 days F, Sa, Su - Multiple territories available - Massive PTO Package - Good work life balance - High-End Market Salary - Elite Clinical Reputation (5-Star CMS Rating) This Jobot Job is hosted by: Ben Eberly Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary: $105,000 - $125,000 per year A bit about us: We are a leading home health care provider with over 40 years of experience delivering compassionate, high-quality care across New York. Recognized with 5-star ratings by the Centers for Medicare & Medicaid Services and National Quality Approval from The Joint Commission, we are consistently ranked among the best in home health by Newsweek. Our culturally diverse team speaks over 15 languages, ensuring personalized care for every community we serve. We pride ourselves on innovation, excellence, and a supportive work environment that feels like family. Here, you’ll find purpose in every role and the opportunity to make a lasting difference in people’s lives. Why join us? ✅ $15,000 Sign-On Bonus after 15 months and full productivity ✅ Competitive Salary: $105K–$125K ✅ Health & Dental Insurance for you and your family ✅ 401(k) with Company Match to secure your future ✅ Tuition Reimbursement for continued education ✅ Generous Paid Time Off: ✅ Referral Bonus Program ✅ Mileage Reimbursement for travel ✅ Continuous Learning & Growth: Free certification programs, ongoing training, and career advancement opportunities ✅ Flexible Scheduling to support work-life balance ✅ Supportive Team Environment that feels like family Job Details Territories available include Bronx, Manhattan, Queens, Brooklyn, or Westchester. What You Will Be Doing Conduct home visits and manage all aspects of patient care in compliance with regulatory standards Complete required documentation, including 485 forms, interim orders, and medication profile updates Communicate with primary care providers and coordinate care with other disciplines Review and complete case communication notes and follow-up items in HCHB Participate in case conferences with supervisors and interdisciplinary teams Maintain accurate and timely records to ensure quality and compliance Skills You Need Active Registered Nurse (RN) License in New York Strong clinical assessment and documentation skills Ability to work independently and manage multiple cases Excellent communication and interpersonal skills Proficiency with electronic health record systems (HCHB preferred) Interested in hearing more? Easy Apply now by clicking the "Apply Now" button. Jobot is an Equal Opportunity Employer. We provide an inclusive work environment that celebrates diversity and all qualified candidates receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. Jobot also prohibits harassment of applicants or employees based on any of these protected categories. It is Jobot’s policy to comply with all applicable federal, state and local laws respecting consideration of unemployment status in making hiring decisions. Sometimes Jobot is required to perform background checks with your authorization. Jobot will consider qualified candidates with criminal histories in a manner consistent with any applicable federal, state, or local law regarding criminal backgrounds, including but not limited to the Los Angeles Fair Chance Initiative for Hiring and the San Francisco Fair Chance Ordinance. Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Jobot, and/or its agents and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here: jobot.com/privacy-policy

The Manager of Billing Compliance has a broad understanding of billing compliance as it relates to Federal and State regulations concerning clinical documentation requirements, billing and reimbursement. CPT/ICD-10 and current HCFA/Medicare regulations governing billing compliance. Responsibilities

Job Description Fractional-CEO for Startup. Founding team is in NYC. Their preference is onsite in Long Island, NY. However, they're open to remote candidates with the right experience. Our client is a PE-backed platform prepared to build nation-wide Home & Community-Based Services (HCBS). They are looking for a Chief Growth Officer that's ambitious and prepared to build a company that'll scale into all 50 states through a mix of organic de-novo launches and rapid M&A. If you've taken HCBS or home-health entities from application to first claim in multiple states, this is your green-field moment. I need 10+ years building or flipping HCBS/HHA entities in 2 or more states. Location • Preferred: On-site with the founding team on Long Island, NY (easy commute from NYC)., • Operational Launch & Scale, • Own every state filing, readiness checklist, survey, and first-claim timeline., • Stand up EVV, scheduling, payroll, and claims across de-novo and acquired agencies., • Regulatory & Clinical Compliance, • Serve as Chief Growth Officer for all state, CMS, and managed-care requirements., • Lead QAPI, incident-management, and continuous-survey preparedness., • M&A Execution, • Partner with PE sponsors on diligence; translate LOIs into operational day-1 plans., • Integrate people, processes, and tech while safeguarding clinical quality., • Payer & Referral Contracting, • Negotiate/network with Medicaid MCOs, Medicare Advantage, PACE, VA Community Care, AAAs, and health-system discharge planners., • People & Culture, • 10+ years building or turning around HCBS/Home-Health agencies in two or more states., • End-to-end experience taking at least two entities from initial application to first paid claim (licensure, waiver enrollment, MCO credentialing, EVV go-live)., • Demonstrated success scaling through both de-novo launches and M&A integration., • Deep working knowledge of §1915(c)/(k) waivers, CMS-855A, ACHC/CHAP/JCAHO standards, HIPAA, EVV, incident reporting, and QAPI., • Track record negotiating multi-state MCO/MA contracts and aligning them with operating economics., • Built or led a national platform backed by private equity., • Builder's Mindset: You see blank maps as playgrounds., • Compliance-First: Quality and safety are non-negotiable., • People-Centric: You scale humans, not just dashboards., • Green-Field Authority: Architect the playbook that wins all 50 states., • PE Firepower: Capital is committed for aggressive de-novo growth and rapid M&A., • National Impact: Keep vulnerable populations healthy at home—at scale., • Career Defining: Be the operations & compliance force behind a future market leader.

Job Description Job Role: Billing Coordinator Location: New York, NY 10017 Shift: Day Pay Rate: $18/hr - $21/hr Duration: 3+ Months Education: High School Diploma Required: 2-3 years of medical billing experience, Medicare, Medicaid and 3rd party reimbursement as well as ICD-9 and CPT coding. Skills: Knowledge of ICD-10 and CPT coding experience, billing practices, proficiency in medical terminology and strong understanding of insurance guidelines and compliance standards. Duties: -Verifies accuracy of billing forms and enters pertinent data in appropriate databases, ensuring timely and optimal reimbursement. -Investigates account billing inquiries, reviewing documentation for completeness and accuracy, including CPT and ICD-9 coding, physician data, insurance coverage, TOA and other data. -Prepares appropriate documentation for account inquiry and resolution. “Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors” Company DescriptionPride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

Job Description THIS ROLE WILL BE ONSITE 5 DAYS PER WEEK IN MANHATTAN, WITH 2-3 DAYS PER MONTH IN THE BRONX. Responsibilities: This position reports to the Benefits Manager and will be responsible for: · Providing assistance in the administration of the non-union employee benefit plans (Medical, Dental, Vision, Life & ADD, FSA, HSA, LTD, Transit, 401(k) etc.) · Act as a liaison with benefit plan vendors for processing claims and billings · Conducting new hire benefit orientations · Providing support in the administration of new eligibility benefit enrollments, changes and terminations for all employee benefit programs · Collaborating with the Benefits Manager in the processing of short-term and long-term disability claims · Family and Medical leave (FMLA) administration · Paid Faily Medical Leave (PFL) administration · Process workers compensation claims · COBRA administration · Auditing and processing monthly vendor bills · Preparing and maintaining of electronic employee personnel and benefit files · Running reports from HRIS system as required · Regularly interacting with the payroll department and management staff regarding employee information and action requests · Updating employee timesheets to record approved family medical leave and paid family leave · Communicating policies and procedures · Supporting the Benefits Manager in conducting annual open enrollment · Work with Benefits Manager, Human Resources Manager, Deputy HR Director and Vice President/Human Resources on various projects · Perform other duties as assigned Job Requirements: BA/BS in Human Resources Management or related discipline, or equivalent experience is preferred. Minimum of an Associates degree or 60 college credits or more is required. **A minimum of 3 years experience in benefit administration is required for lower end salary range and 5 or more years for upper range. The successful candidate will have a proven ability to work independently and as part of a team with the skill to balance multiple projects successfully. Superior administrative and computer skills with a strong knowledge and use of Excel, Word, and HRIS systems essential. Knowledge of UKG HRIS and UKG Ready time and attendance or another Kronos based timekeeping systems a plus. The successful candidate must possess very strong benefit administration skills, be detail oriented and able to multi-task. This is a high demand job requiring the skill to assess and prioritize work projects while collaborating with other departments and team members. Must have excellent organizational, interpersonal and communication skills. Ability to exercise sound judgment, make effective decisions in the best interest of the organization and maintaining required confidentiality and discretion is essential. Up to date knowledge of all pertinent federal and state regulations, filing and compliance requirements both adopted and pending affecting employee benefit programs, including ERISA, COBRA, FMLA, PFL, ADA, Section 125, Workers' Compensation, Medicare, Social Security and DOL requirements. Role is primarily based at main office in Manhattan with occasional work done at our remote HR office in the Bronx. Must be willing to work at both locations as necessary. Bilingual (Spanish) a plus Company DescriptionAward-Winning Architecture FirmAward-Winning Architecture Firm