• Medical Director, Medicare Grievances

    Humana (Albany, NY)
    …clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis and interpretation ... **Preferred Qualifications** + Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction,… more
    Humana (11/19/25)
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  • Pharmacy Product Director - Medicare DSNP

    Highmark Health (Albany, NY)
    …experience in managed care pharmacy + 2 years of clinical account management experience in Medicare as part of the 4 year managed care experience + 2 years of ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of… more
    Highmark Health (11/14/25)
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  • Vendor Operations Oversight Specialist…

    Centene Corporation (New York, NY)
    …auditing, project management, or business analysis experience, preferably within the Medicare field. Previous experience coordinating cross functional teams on large ... Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid time off… more
    Centene Corporation (10/29/25)
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  • Entitlements Specialist

    Project Renewal, Inc. (Bronx, NY)
    …Disability Level II; Public Assistance Level II; Veterans benefits; Medicaid; Medicare ; HMO insurance ). Active problem-prevention and problem-solving measures ... with residents and clinical team. + Responsible for assessing clients for all entitlements programs they may be eligible for + Assist clients in securing documents required for entitlements applications + Maintain an up-to-date resource manual on changes in… more
    Project Renewal, Inc. (09/02/25)
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  • Field Access Manager - South Texas - Houston TX,…

    Merck (Albany, NY)
    …operations, project management, or reimbursement support * Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) and related ... how the products are covered under the benefit design (Commercial, Medicare , Medicaid) * Answer questions about coverage, including payer-specific access questions… more
    Merck (11/27/25)
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  • Specimen Receiving/Reference Laboratory Specialist

    Stony Brook University (Stony Brook, NY)
    …performing billing processes and troubleshooting billing questions according to NYS DOH, Medicare , Medicaid and patient insurance regulations. d. Monitors the ... bills (invoices). Ensures tests are ordered, performed, and billed per Medicare /OIG regulations. f. Audits all test credits performed in Specimen Receiving… more
    Stony Brook University (10/03/25)
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  • Supervisor, Rehab Support Services - Full time…

    Mohawk Valley Health System (Utica, NY)
    …or discrepancies in collaboration with the billing department. + Keep current in Medicare , Medicaid and insurance guidelines. Training & Staff Supervision: + ... & Management: + Accurately collect, verify, and input patient demographic, insurance , and medical information into the hospital's electronic health record (EHR)… more
    Mohawk Valley Health System (11/19/25)
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  • A/R Biller - Full Time

    Mohawk Valley Health System (Utica, NY)
    …in order to promote financial stability within the Hospital. Experience in billing Medicare , Medicaid, Commercial Insurance , HMOs, and Worker's Comp/No Fault is ... a plus. Core Job Responsibilities + Promotes a professional working relationship with insurance companies. Knows each payor representative and uses them as a contact… more
    Mohawk Valley Health System (10/28/25)
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  • CHW/Patient Connection Specialist

    Anthony Jordan Health Corp (Rochester, NY)
    …and documentation skills. . This position requires some expertise in Medicaid, Medicare , and ADAP insurance programs. . Sensitive to confidential information ... salary and full benefits offering including medical, dental, vision, life insurance , and 403b retirement plan. We offer Professional Development allowance. Jordan… more
    Anthony Jordan Health Corp (11/13/25)
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  • Actuarial Analyst 2, Pricing

    Humana (Albany, NY)
    …focused on continuously improving consumer experiences **Preferred Qualifications** + Health insurance experience + Medicare Advantage experience Travel: While ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 11-29-2025 **About us**… more
    Humana (11/14/25)
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