- CVS Health (Albany, NY)
- …address pain points for members, providers, and internal stakeholders. **Backlog Management & Delivery** + Create, prioritize, and manage the product backlog, ... data, user feedback, and market research to enhance digital self-service, claims transparency, provider search, member portals, and mobile applications. + Identify… more
- Guidehouse (New York, NY)
- …client business problems, which include but are not limited to medical and pharmacy claims (open and closed), formulary and managed care data, and EMR data. + ... be able to work independently but with oversight from management . + Prioritize and handle multiple tasks, research, and...Ability to work with large data sets such as claims data. + Excellent attention to detail and ability… more
- The Hartford (Melville, NY)
- …and needs, must be able to make recommendations that will assist the insured's management to correct and prevent the potential for future financial loss. Support of ... Presentations must be clear, concise, and focused. Reports to Management are expected to be submitted in a timely...other approved educational sources such as CPCU/IIA (CPCU, ARM, Claims ), CIC etc. Industry Specific Knowledge and Safety: Have… more
- Actalent (New York, NY)
- …you will manage the owner change directive process and contribute to monthly claims cost reporting. Responsibilities + Collaborate with the Project Manager and team ... directive processes with cost evaluations, estimating, and negotiations. + Prepare monthly claims cost reports. + Conduct internal and external cost reporting for… more
- Humana (New York, NY)
- …operations for higher quality and operational efficiency. + Ensure enrollment and claims processes comply with regulatory requirements and guidelines. + Partner with ... Enrollment Period (AEP). + Utilize tools such as Availity to streamline claims submission, eligibility verification, and authorization processes. + Directly lead a… more
- Humana (Albany, NY)
- …MAAA + 2+ years of actuarial experience in health insurance and/or medical claims analytics + Proficiency in data analysis and one or more statistical programming ... Strong communication skills + Strong working knowledge of healthcare claims as it relates to trend analytics, total cost...it relates to trend analytics, total cost of care management , and/or healthcare economics functions + Medicaid experience +… more
- Robert Half Finance & Accounting (Albany, NY)
- …programs. * Experience in processing and managing Workers' Compensation applications and claims . * Proficiency in database management and record-keeping systems. ... and operational excellence. The ideal candidate will bring expertise in benefits management and a commitment to maintaining strong relationships with internal and… more
- Zurich NA (New York, NY)
- …Diploma or Equivalent and 14 or more years of experience in the Claims or Underwriting Support area within the Commercial Insurance industryOR + Zurich Certified ... and 12 or more years of experience in the Claims or Underwriting Support area within the Commercial Insurance...Commercial Insurance industryAND + 2 or more years of management experience Preferred Qualifications: + Bachelor's Degree + CPCU… more
- Healthfirst (NY)
- …with internal teams (eg, sales, customer service, compliance) to ensure seamless management of members. + Monitor ,report, and deliver updates on memberships, data ... institution + Leadership experience in a high-volume production billing, enrollment, claims , call center environment or related environment. + Basic understanding of… more
- Google (New York, NY)
- …degree or equivalent practical experience. + 4 years of experience in product management , marketing, management consulting, or project management in ... represented in both third-party datasets and Google's internal tools and marketing claims . This includes developing a global strategy to make sure YouTube's… more