- Humana (Albany, NY)
- …the CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience… more
- Humana (Albany, NY)
- …the CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for ... filing, reporting & analysis, reserving or trending) **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience working… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …working weekends and requires frequent travel to various Centers Plans or Healthy Living Advantage Care Medicare HMO Plan sites located throughout the five (5) ... boroughs. Territory Management + Maintain Centers Plans for Healthy Living Advantage Care Medicare HMO Plan visibility in the community by monitoring multiple… more
- Highmark Health (Albany, NY)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- Elevance Health (New Hyde Park, NY)
- …an accommodation is granted as required by law. The **Actuarial Analyst III** supports Medicare Advantage pricing and bid development within the Medicare ... Actuarial team. **How You Will Make an Impact:** Primary duties may include, but are not limited to: + Benefit Ownership: Manage assigned pricing models and benefits, ensuring data accuracy, methodology consistency, and timely bid filing readiness. + Contract… more
- Highmark Health (Buffalo, NY)
- …- Onsite 3 days a week. T, W. Th.** **This role is focused on the Medicare Advantage Stars program. This right candidate for this role will have a foundational ... knowledge of the Medicare Stars program.** **ESSENTIAL RESPONSIBILITIES** + Work with business and technical organizations to drive out program strategy and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …filings and financial statements for assigned business segments. + Leads preparation of Medicare Advantage bids and coordinates CMS bid review responses. + ... current and proposed health plan Underwriting guidelines for commercial and Medicare eligible subgroups. + Consistently demonstrates high standards of integrity by… more
- Humana (Albany, NY)
- …+ **Industry Knowledge** : Familiarity with the healthcare sector, specifically Medicare Advantage , and an understanding of regulatory frameworks and ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... to analyze and report the financial performance for all Commercial and Medicare Contracts with Mount Sinai. The Senior Contracting Analyst has responsibilities that… more
- MVP Health Care (Schenectady, NY)
- …Child Health Plus, Essential Plan, Qualified Health Plans (QHPs), HARP, Off-Exchange, Medicare Advantage (MA) products, and Dual Eligible Special Needs Plans ... (D-SNP). + **Conduct both individual and group outreach activities** to present our innovative health care solutions on- and off-site at various events-from health fairs and community expos to festivals and holiday-themed gatherings-ensuring MVP's presence is… more