- Molina Healthcare (Rochester, NY)
- …Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility from ... processed in accordance with local Health Plan requirements * Works with Claims , Configuration, Contracting, Provider Data Management, and other business partners to… more
- GuideOne Insurance (New York, NY)
- As the Director of Data Platform and AI, you will lead the evolution of our enterprise data infrastructure while spearheading the development of intelligent AI ... of AI and machine learning to address business challenges in underwriting, claims , and service operations. Success in this role demands a pragmatic, collaborative… more
- Centene Corporation (New York, NY)
- …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Molina Healthcare (Albany, NY)
- …by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- Sedgwick (New York, NY)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Client Services Director | REMOTE | Casualty/Workers Compensation Experience required + ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- GuideOne Insurance (New York, NY)
- As the Director of Enterprise Architecture, you will be responsible for leading the architecture strategy, governance, and execution across infrastructure, ... in driving governance and modernization initiatives across multiple domains. As the Director of Enterprise Architecture, you will lead the Architecture Review Board… more
- Molina Healthcare (NY)
- …5 years of experience in Medicare, DSNP and CSNP population, Enrollment, A&G, Claims , Compliance, or other Operations experience To all current Molina employees: If ... you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $88,453 -… more
- Molina Healthcare (Syracuse, NY)
- …with AI Data Integration._** + **_Experience with Member, Enrollment, and Claims applications -_** **which underpin essential business functions such as HEDIS ... reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License, Certification, Association** Microsoft Technology, Mobility, ITIL To all current Molina employees: If you… more
- EAC Network (Garden City, NY)
- Director of Budgets & Contracts - Administration Job Details Level Management Job Location 99 Quentin Roosevelt Blvd Suite 200, Garden City, NY, 11530 - Garden City, ... and NYC, is looking for a dedicated full time Director of Budgets & Contracts to join the Administration...+ Schedule: Monday-Friday 9AM-5PM with some flexibility to work remote + Location: Garden City, NY + Reports to:… more
- AON (NY)
- Aon Is Looking for a Director of Travel Insurance Program Development We currently have an exciting career opportunity for a Director of Travel Insurance Program ... Development with a flexible ( Remote /Hybrid) schedule. This position will support Aon's Travel practice...customer value, and profitability. + Leverage data to analyze claims trends and product performance to inform product and… more
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