• Medicare Coverage Analyst

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: The Medicare Coverage Analyst functions as a key contact person between UMU clinical research departments and sites/hospitals finance for clinical ... trials coverage analyses (CTCA) issues to ensure billing compliance and mitigate risk; reviews budgets on a per-trial basis to ensure accuracy; develop CTCAs timely; documents and disseminates CCA determinations. ensures that final contract terms are… more
    SUNY Upstate Medical University (07/03/25)
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  • Medicare Risk Adjustment Advanced Analytics…

    Elevance Health (Middletown, NY)
    ** Medicare Risk Adjustment Advanced Analytics Analyst ** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,** ... an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics Analyst ** is...law._ The ** Medicare Risk Adjustment Advanced Analytics Analyst ** is responsible for employing advanced analytics to gain… more
    Elevance Health (07/29/25)
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  • Regulatory Analyst , Medicare

    Healthfirst (NY)
    …of material reviews in HPMS. + Actively participates in the annual Medicare Go to Market process, including working with internal stakeholders on developing ... deliverables as needed. + Assists in the preparation of Medicare Part C and D reporting via HPMS, including...knowledge of Microsoft Office Suite applications. + Knowledge of Medicare and CMS guidelines as it relates to member… more
    Healthfirst (06/27/25)
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  • Operational Regulatory Oversight Analyst…

    Molina Healthcare (Rochester, NY)
    …to the Health Care environment. **Knowledge/Skills/Abilities** The Operational/Regulatory Oversight Analyst works with health plans and operations departments to ... to and compliance with State and Federal regulatory guidelines. The Analyst develops and performs audits and oversight functions involving business-critical… more
    Molina Healthcare (07/19/25)
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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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  • Senior Actuarial Analyst ( Medicare…

    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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  • Actuarial Analyst 2

    Humana (Albany, NY)
    …of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting work assignments are varied and frequently require… more
    Humana (07/31/25)
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  • Lead Analyst , Payment Integrity - Health…

    Molina Healthcare (Syracuse, NY)
    …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and shared ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** + Assists… more
    Molina Healthcare (08/03/25)
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  • Provider Enrollment Analyst -Billing-Full…

    Mount Sinai Health System (Astoria, NY)
    **Job Description** **Provider Enrollment Analyst -Billing-Full Time-Day-Mount Sinai Queens** The Provider Enrollment Analyst (I) is responsible for completion of ... preferred. + **Experience:** Two years minimum of healthcare experience including Medicare or Medicaid Provider or Facility Enrollment or Credentialing experience… more
    Mount Sinai Health System (07/30/25)
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  • Reimbursement Analyst (CCS or CPC) Coding…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Reimbursement Analyst (CCS or CPC) Coding Chargemaster/Projects Corporate 42nd Street-Full-Time Days- Hybrid** The Reimbursement Analyst ... in accordance with established fee schedules and ensures compliance with Medicare and other insurance carrier guidelines. **Qualifications** + Associate?s degree in… more
    Mount Sinai Health System (06/07/25)
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