We are seeking an experienced New York Medicaid/MCO Wellness & Gym Program Specialist to help us develop and launch a wellness and fitness program at our physical gym facility located in Jamaica, Queens, New York. Our goal is to develop programs that provide gym, fitness, exercise, wellness, and preventive-health services through appropriate Medicaid/MCO programs and benefits, while also offering private-pay wellness options where appropriate. Responsibilities Research New York Medicaid and MCO gym, fitness, and wellness opportunities Determine the correct NY Medicaid provider type and enrollment pathway Identify applicable NPI taxonomy, CPT/HCPCS, and service codes Research NY Medicaid MCO wellness and value-added benefits Assist with Medicaid enrollment, MCO contracting, and credentialing Communicate directly with MCO Provider Relations and contracting departments Research CBO, HRSN, HCBS, waiver, and other Medicaid program opportunities Develop compliant pathways for reimbursement Identify additional wellness services that may qualify for Medicaid/MCO funding Help structure private-pay memberships, wellness programs, and packages alongside Medicaid/MCO programs Requirements Must have New York Medicaid/MCO experience Proven experience with Medicaid managed care, contracting, reimbursement, or program development Knowledge of NY Medicaid provider enrollment Experience with MCO/provider contracting Understanding of wellness, fitness, preventive-health, or community-based programs Knowledge of

CPT/HCPCS, NPI

taxonomy, and reimbursement Experience with private-pay wellness programs is a plus This is NOT a standard medical billing position. We need someone who understands the New York Medicaid/MCO system and can help us build the program from provider enrollment → contracting → program development → reimbursement, while also developing appropriate private-pay options.

Keywords:

NY Medicaid, New York Medicaid, Medicaid Managed Care, MCO Contracting, Wellness Program, Gym Program, Fitness Benefits, Medicaid Provider Enrollment, NY Medicaid Credentialing, Healthcare Reimbursement, Payer Contracting, Provider Relations, Community-Based Organization, CBO, HRSN, HCBS, Medicaid Waiver, Value-Added Benefits, CPT, HCPCS, NPI Taxonomy, Private Pay Wellness.

Job Location:

Jamaica, Queens, NY Pay:

$25.00 - $50.00 per hour

Pay:

$25.00 - $50.00 per hour

Work Location:

Hybrid remote in Jamaica, NY