- Centene Corporation (Queens, NY)
- …NCQA, HIPAA, and other regulatory bodies. + Oversee implementation and optimization of health plan operations systems (eg, claims adjudication platforms, CRM ... Centene is transforming the health of our communities one person at a...everything for our 28 million members. **Position Purpose:** Oversee operations , procurement opportunities, new product implementations and initiatives for… more
- Northwell Health (New York, NY)
- **Req Number** 173504 Job Description The AVP for Health Plan Performance will be responsible for driving the performance of our network solution across ... coordination and administration of policies, services and programs that optimize health plan performance for Northwell Direct. Collaborates with leadership… more
- Highmark Health (Albany, NY)
- …sales narratives and messaging for our products, networks, reimbursement, clinical services, UM, and health plan operations in a powerful and compelling way ... RESPONSIBILITIES** + Collaborate with matrixed partners to define and refine Highmark Health Plan 's sales narratives in a compelling way that establishes… more
- Highmark Health (Albany, NY)
- …and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations . **ESSENTIAL RESPONSIBILITIES** + Perform management ... business. This will require aligning new models to the health plan 's strategic objectives based on a...Plan , organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and… more
- Evolent (Albany, NY)
- …into actionable strategies. + **Industry Knowledge:** Deep understanding of value-based care, health plan operations , and provider partnerships. + ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Management, Product Development, Medical Management, Marketing & Sales, etc. and how they impact Health Plan operations , financials and forecasts. + In depth ... rating methods and models. + Provides guidance to the Health Plan product development process. + Oversees...operations . + Provides counsel on current and proposed health plan Underwriting guidelines for commercial and… more
- Healthfirst (NY)
- …using Agile methodologies. Exposure to Scaled Agile (SAFe) preferred. + Experience working with health plan operations and IT + Experience working as a ... by collaborating closely with peers, leaders, and staff throughout Operations to ensure the appropriate parties are contributing. +...+ Experience leading large scale change initiative in a health plan setting + Demonstrated understanding and… more
- Datavant (Albany, NY)
- …for storage and computing + Experience with machine learning algorithms + Knowledgeable in health plan operations and reporting We are committed to building ... a data platform company and the world's leader in health data exchange. Our vision is that every healthcare...Our platform is powered by the largest, most diverse health data network in the US, enabling data to… more
- Trinity Health (Albany, NY)
- …of management experience, to include but not limited to experience leading hospital operations at an integrated health care entity. Advanced business and ... **Employment Type:** Full time **Shift:** **Description:** **ST. PETER'S HEALTH PARTNERS** More than 150 years ago, the Religious Sisters of Mercy, Daughters of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Associate Dir, Health Systems & Process Improvement- Health System Operations -Full-Time-Days -Hybrid** The Associate Director of ... and Process Improvement is responsible for supporting the day-to-day operations of the Health Systems and Process...all levels of organization and ensuring alignment with strategic plan of Mount Sinai Health System +… more