• Medical Director - IP Claims Management

    Humana (Albany, NY)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage , and Medicaid requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (12/11/25)
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  • Medical Director - Nat'l IP UM Team

    Humana (Albany, NY)
    …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand ... hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial products, or other… more
    Humana (11/15/25)
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  • Outreach and Retention Associate

    Centers Plan for Healthy Living (Staten Island, NY)
    …the guidance and plans they need for healthy living. Outreach and Retention Associate (ORA)- Medicare Advantage CPHL is a Medicare Advantage Prescription ... Medicare products *Licensed Agents Only. + Educate potential members about Medicare Advantage / Special Needs Plans and the benefits of enrolling in the CPHL… more
    Centers Plan for Healthy Living (10/14/25)
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  • Medical Director - OneHome

    Humana (Albany, NY)
    …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare more
    Humana (12/30/25)
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  • OneHome - Medical Director - Part Time

    Humana (Albany, NY)
    …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare more
    Humana (11/27/25)
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  • BI Analyst

    Humana (Albany, NY)
    …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to ... to drive business outcomes and decisions + Experience in Medicare /Medicaid, CMS (Centers for Medicare & Medicaid...+ Experience in Medicare /Medicaid, CMS (Centers for Medicare & Medicaid Services) or other Federally regulated healthcare… more
    Humana (12/19/25)
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  • Growth Strategy Manager

    Humana (Albany, NY)
    … and Medicaid's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Manager, you will deconstruct issues ... Humana's businesses. The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana's largest, which comprises over 80% of the… more
    Humana (12/29/25)
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  • Medical Director, Medical Policy

    Highmark Health (Albany, NY)
    …knowledge to the team. They support the full-cycle ownership of commercial and Medicare Advantage medical policies, both developed internally and by vendors. ... as required. **ESSENTIAL RESPONSIBILITIES** + Full-cycle ownership of commercial and Medicare Advantage medical policy creation process including writing… more
    Highmark Health (12/24/25)
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  • Health Insur & Auth Rep III

    University of Rochester (Rochester, NY)
    …on policy, Cobra entitlement, Medicare Lifetime Reserve days, and Medicare Advantage issues. Communicates, collaborates, and follows-up with patients, ... of adding newborns onto policy. Determines the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits. + Notifies… more
    University of Rochester (01/02/26)
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  • Health Insur & Auth Rep III

    University of Rochester (Rochester, NY)
    …on policy, Cobra entitlement, Medicare Lifetime Reserve days, and Medicare Advantage issues. This role involves in-depth communication, collaboration, and ... adding newborns onto policy. + Determine the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits. + Notify… more
    University of Rochester (12/15/25)
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