• Senior Contract Manager Analyst - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …+ Opportunity to work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation ... compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on:… more
    Mount Sinai Health System (08/01/25)
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  • Provider Enrollment Analyst-Billing-Full…

    Mount Sinai Health System (Astoria, NY)
    …and re-credentialing functions, including meeting requirements for government, commercial, managed care, and other health plan credentialing following an ... Queens **Responsibilities** + Ensure enrollments for new providers in Medicaid, Medicare, Managed Care plans, Commercial Health plans and Exchange plans. + Identify… more
    Mount Sinai Health System (07/30/25)
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  • Senior Risk Partner - Compliance Officer

    Highmark Health (Albany, NY)
    …and state rules as well as a solid working knowledge of managed care operations, compliance program structures, information security and audit methodologies. The ... partner and advisor to business leaders to ensure business decisions are managed according to the enterprise risk strategy / framework.Participates in and… more
    Highmark Health (07/29/25)
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  • Medical Director - NorthEast Region

    Humana (Albany, NY)
    …such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or ... in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines… more
    Humana (07/25/25)
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  • Director, HARP Care Management

    Healthfirst (NY)
    …or Licensed Master Social Worker (LMSW) + 7 years of behavioral health experience in managed care and/or a clinical setting with at least 2 years of that experience ... being in managed care + Progressive leadership experience in medical and...familiarity with New York State HARP, HCBS, and Medicaid Managed Care programs **Preferred Qualifications:** + Clinical and leadership… more
    Healthfirst (07/25/25)
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  • Senior Paralegal

    Molina Healthcare (Rochester, NY)
    …under the direction of the Deputy General Counsel, on a wide variety of managed care legal and other matters. **Job Duties** * Draft and prepare regulatory filings ... years' experience as a paralegal, including at least 3 years of managed healthcare experience with an understanding of Medicare, Medicaid, and Marketplace… more
    Molina Healthcare (07/24/25)
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  • Field Care Manager, Ltss (RN)

    Molina Healthcare (NY)
    …candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage is reimbursed as part of our benefits ... Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. +...Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. +… more
    Molina Healthcare (07/20/25)
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  • Provider Contracts Manager

    Molina Healthcare (Buffalo, NY)
    …in the health care field including, but not limited to, provider's office, managed care organization, or other health care environment. * 3+ years experience in ... provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital… more
    Molina Healthcare (07/17/25)
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  • Medical Director- South Central

    Humana (Albany, NY)
    …(such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or ... in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines… more
    Humana (07/11/25)
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  • AVP, Private Assets Operations - Private Credit

    Aflac (New York, NY)
    …works within the US Chief Operating Officer Group in support of private assets managed internally and externally. The position will work in support for all middle ... management team responsible for private debt and alternative assets for externally managed mandates. Assist in performing daily operational activity to support funds… more
    Aflac (07/06/25)
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