• Medicare Advantage Quality Consultant

    Highmark Health (Buffalo, NY)
    …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
    Highmark Health (11/06/25)
    - Related Jobs
  • Sr. Medicare (PPS) Provider Hospital…

    Humana (Albany, NY)
    …a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer ... Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team continue to… more
    Humana (10/18/25)
    - Related Jobs
  • Medicare MAP Advisor

    Centers Plan for Healthy Living (Staten Island, NY)
    …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and...Medicaid Services (CMS) and company policies and regulations. The Medicare MAP advisor will develop a presence in the… more
    Centers Plan for Healthy Living (10/14/25)
    - Related Jobs
  • Senior Program Manager, Medicare Stars…

    Molina Healthcare (Rochester, NY)
    **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality improvement ... and education programs to support improved Star Ratings. Responsible for Medicare Star projects and programs involving enterprise, department, cross-functional and… more
    Molina Healthcare (10/17/25)
    - Related Jobs
  • AVP, General Manager - Medicare - NY/NJ…

    CVS Health (Albany, NY)
    …every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products in their market, supporting ... of medical costs management, compliance, and revenue integrity efforts for all Medicare Advantage products (inclusive of collaborating with the Employer Group team… more
    CVS Health (11/22/25)
    - Related Jobs
  • Medicare Sales Specialist Hourly…

    CVS Health (Albany, NY)
    …talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part of a specialized team ... who will focus on educating existing Medicare members on available plan offerings to help meet...Work defined campaigns that are designed to assist Aetna Medicare members holistically find the appropriate Aetna Medicare more
    CVS Health (11/13/25)
    - Related Jobs
  • Medicare Compliance Analyst

    Molina Healthcare (Buffalo, NY)
    **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a ... **KNOWLEDGE/SKILLS/ABILITIES** The Compliance Analyst position is primarily responsible for Medicare Oversight. + Provide regulatory expertise to the Organization:… more
    Molina Healthcare (11/23/25)
    - Related Jobs
  • Behavioral Health Medical Director…

    Humana (Albany, NY)
    …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... includes some experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing Board Certification in an… more
    Humana (11/11/25)
    - Related Jobs
  • Medical Director, Nat'l OP Medicare

    Humana (Albany, NY)
    …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
    Humana (11/07/25)
    - Related Jobs
  • Medicare Field Sales Representative

    MVP Health Care (Schenectady, NY)
    …thinking and continuous improvement. To achieve this, we're looking for a ** Medicare Field Sales Representative** to join #TeamMVP. This is the opportunity for ... multi-cultural environment. Must be sensitive to the needs of Medicare -eligible populations, including individuals with chronic conditions and disabilities. +… more
    MVP Health Care (10/07/25)
    - Related Jobs