- Molina Healthcare (Albany, NY)
- **Job** ** ** **Summary** Safeguard member trust and plan compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- Highmark Health (Buffalo, NY)
- …working with health care data and analytics + Experience in Lean, Six Sigma, risk management , contract management , finance management **SKILLS** + ... be directly responsible for outcomes of providers contracted in the Organization's gain/ risk share arrangements and is a highly skilled expert in practice… more
- Evolent (Albany, NY)
- …primarily focused on performing medical economics analysis in support of complex risk -based contract development and will partner with stakeholders of various levels ... across analytics, finance, and account management . **What You Will Be Doing:** + Develop and...presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based… more
- Citigroup (Getzville, NY)
- …* Strong communicator who is articulate and concise, written and verbal * Strong risk management and control mindset * Provides evaluative judgment based on ... & Derivatives Associate Analyst is responsible for investigating and settling compensation claims internally and externally for the EMEA and NA Capital Market… more
- Zurich NA (New York, NY)
- …leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We ... and 10 or more years of experience in the Claims , Underwriting support areaOR + Zurich Certified Insurance Apprentice...location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a… more
- MetLife (New York, NY)
- …Europe, and the Middle East. With over 150 years of disciplined risk - management experience, MetLife provides deep expertise in skillfully navigating markets ... with the goal of delivering strong, risk -adjusted returns. The firm's client-centric culture enables a singular...automation: Given the exponential growth of the Pet business, claims cost management is essential. Enhance auto-adjudication… more
- Molina Healthcare (Syracuse, NY)
- …regulatory compliance audit procedures. * At the direction of management , coordinates and performs oversight audits and validation activities to ensure ... laws and regulations, which will protect the Business from liability and potential risk . Ensures that the Business understands and complies with applicable laws and… more
- Catholic Health Services (Smithtown, NY)
- …named Long Island's Top Workplace! Job Details Position Summary The Per Diem Risk Management Admin Assistant provides administrative and clerical support to the ... Risk Management Department. This role is responsible...& Communication Support Prepare agendas, handouts, and minutes for risk , safety, and claims review meetings. Support… more
- MTA (New York, NY)
- …entire lifecycle of the Interborough Express including budgeting, cost control, scheduling, risk management , and contract management . Program control ... include monitoring actual project performance; anticipating and forecasting potential claims ; negotiating and resolving claims /disputes; ensuring proper… more
- NASCO (Albany, NY)
- …to deliver data-driven SaaS solutions that enhance healthcare payer operations, risk management , and member engagement. **Responsibilities** Governance + Manages ... governance for AI implementation including ethics, model management and explainability, bias mitigation, and compliance with evolving regulations + Reviews and… more