• Waiver Grants/ Claims Manager

    Catholic Charities of the Dioscese of Albany (Albany, NY)
    …closeout reports + Update the Schedule of Expenditures of Federal Grants (SEFA) + Claims processing + Reconcile all 1115 Waiver bills submitted to funders with ... Your Career? Be the Change: Become the 1115 Waiver Grants/ Claims Manager at Catholic Charities! Are you ready to... Manager at Catholic Charities! Are you ready to lead with purpose and passion? At Catholic Charities, we're… more
    Catholic Charities of the Dioscese of Albany (10/07/25)
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  • Lead Analyst, Payment Integrity - REMOTE

    Molina Healthcare (Syracuse, NY)
    …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... **Job Description** **Job Summary** Provides lead level support as a highly capable business...operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to… more
    Molina Healthcare (09/28/25)
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  • Lead Data Scientist - Research…

    Highmark Health (Albany, NY)
    …progressions, and treatment efficacy? Highmark Health is seeking a groundbreaking Lead Data Scientist, Research & Development, specializing in Graph Intelligence, ... insights in healthcare. This is a premier R&D position where you will lead the charge in inventing and proving out transformative graph-native analytical solutions.… more
    Highmark Health (08/29/25)
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  • Lead Analyst, Reimbursement

    Molina Healthcare (Buffalo, NY)
    …contracts, pricing configuration, claim adjudication or reimbursement processes + Experience processing or reviewing facility claims + Prior professional ... **Job Description** **Job Summary** The Lead Analyst, Reimbursement is responsible for administering complex provider reimbursement methodologies timely and… more
    Molina Healthcare (09/27/25)
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  • App Dev RFP_Solution Lead - AEM

    Capgemini (New York, NY)
    …using APIs and middleware Deep understanding of insurance workflows such as underwriting claims processing and policy servicing Familiarity with cloud based AEM ... App Dev RFP_Solution Lead - AEM Choosing Capgemini means choosing a company...integration with core insurance systems such as policy administration claims billing and CRM platforms Establish reusable components development… more
    Capgemini (10/04/25)
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  • Lead Data Scientist, Document Intelligence…

    Guardian Life (New York, NY)
    **Position Overview** ** Lead Data Scientist, Document Intelligence & AI Agents** Guardian is on a transformation journey to evolve into a modern, forward-thinking ... of pioneering research into practical, enterprise-wide solutions. In this role as Lead Data Scientist for the DSL, you'll be entrusted with developing solutions… more
    Guardian Life (08/22/25)
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  • Test Lead - Pharmacy Business Solutions

    EPAM Systems (New York, NY)
    …into E2E testing strategies + Develop and communicate test strategies covering pharmacy claims processing , NCPDP transactions, and benefit designs + Design test ... Lead the planning, strategy, and coordination of end-to-end...large, complex, cross-functional teams + Extensive knowledge of pharmacy claims adjudication, NCPDP protocols, formulary management, and benefit design… more
    EPAM Systems (10/07/25)
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  • AI Innovation Lead - Data Science Lab

    Guardian Life (Albany, NY)
    ** Lead AI Innovation Lead - Data Science Lab** **Overview** Guardian is on a transformation journey to evolve into a modern, forward-thinking insurance company ... of pioneering research into practical, enterprise-wide solutions. In this role as Managing Lead Data Scientist for the DSL, you'll be entrusted with the crucial task… more
    Guardian Life (09/12/25)
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  • Medicaid State Technology Lead

    Humana (Albany, NY)
    …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... and help us put health first** The State Technology Lead understands departmental and IT organizational strategy and operating...transitioned smoothly to markets. + Works with the Test Lead to develop plans of action for testing new… more
    Humana (09/03/25)
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  • Lead Data Scientist - AI

    CVS Health (New York, NY)
    …day. The Specialty Pharmacy AI team is seeking a highly motivated and experienced Lead Data Scientist to play a role in designing and executing AI solutions, with ... a particular focus on Generative AI. The individual will serve as the technical lead for a portfolio of 3 to 5 AI projects and will work in collaboration with a… more
    CVS Health (08/08/25)
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