- Molina Healthcare (Rochester, NY)
- …and appeals. * Records calls accurately within the pharmacy call tracking system . * Maintains established pharmacy call quality and quantity standards. ... calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and … more
- St. Mary's Healthcare (Amsterdam, NY)
- St. Mary's Healthcare has been providing high- quality , compassionate healthcare to the people of Montgomery and Fulton counties since 1903. At St. Mary's Hospital, ... Region to earn the distinction since the Times Union launched the recognition program 14 years ago. Job Requisition: REQ3915 Employment Type: Full-Time Shift: Days… more
- Highmark Health (Albany, NY)
- …ACO), alternative reimbursement models (eg, bundled payments), and provider / health plan quality programs (eg pay for performance) + 5 years Familiarity with ... Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Levels * Represents the company in meetings and communications with NYSID, CMS , BCBSA, consultants, customers and other external parties. * Ensures actuarial ... Actuarial Standards Board. * Prepares actuarial statements of opinion for filings to NYSID, CMS and the NAIC where opinions are required to be signed by a qualified,… more
- Elevance Health (New York, NY)
- …proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in ... The **Medical Director, Cardiology** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and… more
- Molina Healthcare (Rochester, NY)
- …Key areas of focus will include performance improvement, project planning and management , financial and operational analyses, corporate strategy development, and ... required **Required Experience** * Five years of experience in transformation, change management , strategy consulting, or internal corporate strategy . *… more
- CVS Health (Albany, NY)
- …for all colleagues** including wellness screenings, tobacco cessation and weight management programs , confidential counseling and financial coaching. + **Benefit ... implementation. Projects will support population health and will primarily impact Stars and quality but will also focus on improvements in utilization and cost. The… more
- Amazon (New York, NY)
- …and content platforms). You will own the Journey Orchestration program from end-to-end including strategy , deployment, measurement and optimization with ... hands-on martech implementation experience. By pairing lifecycle marketing and web strategy with technical fluency across CRMs, CDPs, marketing automation, and… more
- Molina Healthcare (Buffalo, NY)
- …leader within the organization enterprise wide. This position advises senior management , other corporate departments, and Molina health plans on Risk Adjustment/RADV ... functions include, but may not be limited to: chart retrieval strategy , risk adjustment retrieval performance, process effectiveness, market performance, project… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …claim payments, and enrollment in accordance with MTM, Corporate Service strategy , NCQA, and legislative requirements. The Customer Care Advocate provides service ... products, services and policies in accordance with MTM, NCQA, HIPAA, NYSDOH, CMS and other legislative requirements. + By utilizing appropriate resources, resolves… more
Recent Jobs
-
Sr. Applied Scientist - Privacy, Privacy Engineering
- Amazon (Seattle, WA)
-
Tactical Weapon System Chief Engineer
- BAE Systems (Rockville, MD)
-
IT disaster Recovery Analyst
- Two95 International Inc. (Portland, OR)
-
Field Trip Clerk - Transportation Dept
- Gwinnett County Public Schools (Suwanee, GA)