- Humana (Albany, NY)
- …review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or ... part of our caring community and help us put health first** The Medical Director relies on medical background...and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will… more
- Humana (Albany, NY)
- …+ Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing ... part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts...role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside… more
- Highmark Health (Buffalo, NY)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and...of user interfaces, predicative analytic tools, and other population health management tools endorsed by Highmark. + Independently and… more
- CVS Health (Albany, NY)
- … in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health 's unrivaled ... the management and organization of plan activities at the health plan as it relates to the Medicare...internal and external clients is required. + Knowledge of insurance regulatory and contractual requirements. + Knowledge of value… more
- Humana (Albany, NY)
- …or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice ... materials, internal teaching conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage… more
- CVS Health (Albany, NY)
- …MAPD/DSNP product offerings + Ability to pass, on an annual basis: + American Health Insurance Plans (AHIP) + Continued Education (CE's) + Product Certification ... an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part...1 to 2 years demonstrated sales experience + Active Health insurance license or willingness to obtain… more
- CenterWell (Albany, NY)
- …+ Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managedMedicaid, or Commercial health insurance . + ... or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice… more
- MVP Health Care (Schenectady, NY)
- …combination of education and related experience. + Active NYS Accident & Health Insurance License (must maintain continuous licensure). + Valid driver's ... At MVP Health Care, we're on a mission to create...continuous improvement. To achieve this, we're looking for a ** Medicare Field Sales Representative** to join #TeamMVP. This is… more
- Humana (Albany, NY)
- **Become 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 ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team continue… more
- Centene Corporation (Buffalo, NY)
- …with company's policies and programs. Provide greater access to health insurance , by providing education and assistance to Medicare individuals. Distribute ... health screenings. Provide Facilitated Enrollment, help facilitate the continuance of health insurance , and offer assistance with recertification. + Identify… more