• Medicare Outside Sales Rep

    Healthfirst (Enfield, NY)
    …implementation throughout the year. + Assist with corporate initiatives related to Medicare quality or STAR ratings- ie HRAs/FPL/MSP. + Successfully pass audit ... (educational and marketing) exams. + Additional duties as assigned. **Work Location** **The Outside Sales Rep will work at locations they develop within their designated territory, or they may need to visit prospects homes.** **Minimum Qualifications &… more
    Healthfirst (08/08/25)
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  • Senior Business Analyst ( Medicare

    Molina Healthcare (Rochester, NY)
    …business analysis, task and workflow analysis. + Subject matter expert of Medicare and Healthcare enrollment 834 files. + Interpret customer business needs and ... translate them into application and operational requirements + Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as… more
    Molina Healthcare (07/27/25)
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  • Supervisor IV-Patient Financial Services…

    Mount Sinai Health System (New York, NY)
    **Job Description** Supervisor IV-Patient Financial Services ( Medicare and Medicaid Claims Follow-Up) Corporate- Full-Time Days Responsible for the supervision and ... coordination of administrative and general office activities, consistent with departmental objectives, administrative policies and practices. Provides direct supervision for administrative and office support staff such as secretarial/administrative assistants,… more
    Mount Sinai Health System (07/27/25)
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  • Senior Actuarial Analyst ( Medicare Risk…

    Molina Healthcare (Syracuse, NY)
    **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate risk scores, and analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment… more
    Molina Healthcare (07/25/25)
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  • Senior Medical Director ( Medicare )

    Molina Healthcare (Yonkers, NY)
    …License without restrictions (free of sanctions from Medicaid or Medicare ) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare ... Administration, etc. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Board Certification (Pediatrics, Family Practice, Ob/Gyn or Internal Medicine). **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate.… more
    Molina Healthcare (06/13/25)
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  • Manager Patient Accounting-Patient Financial…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Manager Patient Accounting-Patient Financial Services ( Medicare /Medicaid) Corporate-Full-Time Days** The Manager is responsible for overseeing ... staff, operations and resources within a department or division to ensure optimal result and high employee engagement. The Manager ensures that the department is run according to institutional policies and any applicable regulatory requirements.… more
    Mount Sinai Health System (06/05/25)
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  • Provider Service Team Lead ( Medicare

    TEKsystems (Schenectady, NY)
    …Lead is responsible for responding to all Department of Health audit calls on a consistent basis and serving as a the lead & subject matter expert for the team Acts ... as a liaison between our internal and external customers. Responds promptly, accurately, and effectively to all calls in a polite and professional manner. Responds to all calls timely and have a clear understanding of call avoidance, such as but not limited to… more
    TEKsystems (08/23/25)
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  • Program Director - Medicare Duals (Remote)

    Molina Healthcare (NY)
    …**Job Summary** Responsible for the Management of internal business projects and programs involving department or cross-functional teams of subject matter experts, ... delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs, and monitors… more
    Molina Healthcare (08/22/25)
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  • Director, Provider Network Management & Analytics…

    Molina Healthcare (Buffalo, NY)
    …**Job Summary** Responsible for accurate and timely measurement of critical provider analytics including Network Adequacy and other critical metrics. Synchronizes ... data among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data on provider databases and ensure adherence to business, system and regulatory requirements of Provider Data Management/Network Adequacy.… more
    Molina Healthcare (08/20/25)
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  • Medical Director - Medicare Appeals

    CVS Health (Albany, NY)
    …Aetna, a CVS Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We ... At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans… more
    CVS Health (08/08/25)
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