• Director, Operational Oversight (Medicare/Duals)…

    Molina Healthcare (Albany, NY)
    …* Demonstrated skill in root-cause triage that routes each complaint to the correct business owner on first touch. 2. Resolution Quality & Compliance Mastery * Track ... ability to codify best practices and embed them across multiple lines of business * Comfortable building business cases and securing resources across IT,… more
    Molina Healthcare (07/29/25)
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  • Lead Analyst, Configuration Oversight - Payment…

    Molina Healthcare (Syracuse, NY)
    …data for review and distribution. + Accurately interprets end to end business requirements and able to confirm outcomes meet the specific state/federal requirements. ... accuracy of new complex configuration processes/solutions + Interprets complex business problems and technical issues + Effectively communicates audit findings… more
    Molina Healthcare (07/24/25)
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  • Pharmacy Analytics Consultant II

    CDPHP (Latham, NY)
    …request for more influential impact. + Demonstrates intermediate understanding of healthcare products and operational business knowledge. + Demonstrated analytic ... with a multidisciplinary team (eg, clinical, financial, sales, and Line of Business Leaders) to recommend actionable items leading to positive pharmacy financial… more
    CDPHP (07/30/25)
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  • Program Director - Medicare Duals (Remote)

    Molina Healthcare (NY)
    **JOB DESCRIPTION** **Job Summary** Responsible for the Management of internal business projects and programs involving department or cross-functional teams of ... compliance to AVP, VP and senior management + Consultative role, develops business case methodologies for programs, develops and coordinates implementation of … more
    Molina Healthcare (08/22/25)
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  • Third Party Contracting Analytics Manager

    KPH Healthcare Services, Inc. (East Syracuse, NY)
    …contact for PBM contract negotiations. + Prepare financial models and business cases to support negotiation strategies. + Negotiate reimbursement rates, discount ... + Perform other duties as assigned. **Qualifications** **Education:** + Minimum: AS in Business Management, or related field + Preferred: BS in Business more
    KPH Healthcare Services, Inc. (08/01/25)
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  • Medicare Compliance Manager (Medicare Advantage…

    Molina Healthcare (Rochester, NY)
    …and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the ... Business understands and complies with applicable laws and regulations...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
    Molina Healthcare (07/25/25)
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  • Regional Vice President (RVP) of Operations…

    Genesis Healthcare (NY)
    …define and achieve regional performance targets and manage profit and loss (P&L). Business Development and Growth: 1. Identifies and pursues new business ... Qualifications SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS: 1. A Bachelor's degree in business administration, health administration, or a related field is… more
    Genesis Healthcare (07/17/25)
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  • Director, Compliance ((Must reside…

    Molina Healthcare (Buffalo, NY)
    …and/or detects violation of applicable laws and regulations, which will protect the Business from liability of fraudulent or abusive practices. Ensures that the ... Business understands and complies with applicable laws and regulations...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
    Molina Healthcare (07/12/25)
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  • Facilitated Enroller (In Field - Buffalo, NY)

    Molina Healthcare (Albany, NY)
    …and assisting current members who are due to re-certify their healthcare coverage by completing the annual recertification application including adding on ... hours per week + Establish and maintain good working relationships with external business partners such as hospital and provider + organizations, city agencies and… more
    Molina Healthcare (08/31/25)
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  • Manager, Medical Economics (Vbc) - Remote

    Molina Healthcare (NY)
    …meet data analysis and database development needs. + Reviews, evaluates, and improved business logic and data sources. + Resource to staff for mentoring, coaching, ... + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL 2005/2008 SSRS and Power BI… more
    Molina Healthcare (08/31/25)
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