• Lead Analyst, Payment Integrity - REMOTE

    Molina Healthcare (Syracuse, NY)
    …integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape ... **Job Description** **Job Summary** Provides lead level support as a highly capable business...as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan… more
    Molina Healthcare (09/28/25)
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  • Specialty Sales Representative, Immunology

    Grifols Shared Services North America, Inc (Albany, NY)
    …contract strategy, and represent needs of the customer. *Remain cognizant of managed care coverage throughout the business territory including major accounts ... like pharmacy DOP and Emergency Room. As the sales lead for a given geography(territory) the SSR will need...to business customers. The SSR will liaise with Marketing, Managed Markets, Operations, CL&D, Medical Affairs and Telesales to… more
    Grifols Shared Services North America, Inc (10/08/25)
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  • Senior Director, Patient Financial Services…

    Mount Sinai Health System (New York, NY)
    …and EHR systems. + Organizes routine meetings with health system business leaders and managed care to review payer issues and denials. + Builds effective, ... of the MSHS. **The Senior Director is a key leader within the Patient Financial Services Management team, responsible...with key stakeholders across departments (eg, DTP, Human Resources, Managed Care , Finance, and clinical departments) +… more
    Mount Sinai Health System (08/12/25)
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  • Senior Contracting Compliance Analyst…

    Mount Sinai Health System (New York, NY)
    …clinical, contracting, finance, IT, analytics, operations, and product development expertise. The Managed Care Contracting Team within MSHP is responsible for ... Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as...Issues: * Proactively escalate issues to Directors that could lead to significant legal ramifications or require intervention by… more
    Mount Sinai Health System (10/08/25)
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  • Medical Director - Florida

    Humana (Albany, NY)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (10/03/25)
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  • Medical Director-Payment Integrity

    Humana (Albany, NY)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient… more
    Humana (09/26/25)
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  • Medical Director - Mid West Region

    Humana (Albany, NY)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
    Humana (09/16/25)
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  • Senior Program Associate

    New York University (New York, NY)
    …and motivated individual to serve as a senior program associate for our Managed Care Technical Assistance Center (MCTAC) and Healthcare Innovation team. This ... and training resources. The Program Associate may also support the projects of the Managed Care Technical Assistance Center (MCTAC), an initiative funded by the… more
    New York University (08/07/25)
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  • Medical Director - Northeast Region

    Humana (Albany, NY)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an… more
    Humana (07/25/25)
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  • Field Reimbursement Manager, Immunology…

    J&J Family of Companies (New York, NY)
    …to address critical access and affordability issues for patients. + Partner with managed care colleagues to understand current policies and potential future ... and affordability solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in accordance with the… more
    J&J Family of Companies (10/03/25)
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