- Molina Healthcare (Yonkers, NY)
- …outcomes and benefit realization + Demonstrates deep understanding of Core Operations , Claims and Enrollment processes, deliverables, vendor partners and ... productivity, quality, compliance + Articulates the goals and objectives of Molina Healthcare business units to vendors supporting operations of those units… more
- Molina Healthcare (Albany, NY)
- …CMS timelines. 2. Workflow Integration - Embed CTM insights into downstream operations -Stars, appeals & grievances, enrollment, claims -so each team addresses ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- Healthfirst (NY)
- …Qualifications** + Demonstrated experience or deep understanding of healthcare Operations processes and supporting systems such as Claims Processing, ... + Experience in Healthcare /Health Plan customer service, operations , vendor management, or claims processing. +...Demonstrated experience or deep understanding of healthcare Operations processes and supporting systems such as Claims… more
- Evolent (Albany, NY)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Molina Healthcare (Rochester, NY)
- …managed care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations , Hospital or Physician Billing, or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- Molina Healthcare (Yonkers, NY)
- …The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace lines ... across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice,… more
- Bank of America (New York, NY)
- …If you are a mid-career product management professional with expertise in healthcare claims payments, clearinghouse / payer technology solutions, revenue cycle ... Healthcare Solution Product Manager Atlanta, Georgia;New York, New... industry: powering faster electronic payments, automating revenue cycle operations , and enhancing the digital patient experience. The future… more
- KPH Healthcare Services, Inc. (Syracuse, NY)
- …for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate financial and clinical ... for services. **Travel** : Limited travel may be required. Travel to healthcare providers and to various business and management conferences required. Travel to… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- **Position Summary** The Senior Manager, Fleet & Samples Operations oversees the execution of field fleet logistics and pharmaceutical sample distribution. The role ... reliability, and compliance while collaborating closely with the Field Strategy & Operations team to meet field force needs. **Key Responsibilities** **Fleet … more
- Kyndryl (Albany, NY)
- …Contact Center operations for enterprise organizations, particularly those in the Healthcare or State or Local Government and / or Educational (SLED) spaces. ... innovative solutions that enhance customer journeys, improving customer technology operations , and integrate cutting-edge capabilities such as Agentic AI. The… more