- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... support executive decision-making. + Research and develop reports and analysis for senior management; effectively communicate results. + Assist in the preparation of… more
- 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 (Yonkers, NY)
- …License without restrictions (free of sanctions from Medicaid or Medicare ) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare ... Administration, etc. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Board Certification (Pediatrics, Family Practice, Ob/Gyn or Internal Medicine). **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate.… more
- Molina Healthcare (Syracuse, NY)
- …**Job Summary** Leads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in ... development of MHI's business process improvement methodology and in the implementation of a business process improvement capability. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for most complex process analysis, design, and simulation. + Requires highest… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division of ... & Marketplace Integration (DEMI)** **Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries** **Telecommuting Option:** This position is… more
- Elevance Health (East Syracuse, NY)
- …Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare... Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A… more
- CVS Health (Albany, NY)
- …We are seeking a strategic and technically proficient leader to oversee Medicare data science initiatives supporting actuarial analytics and pricing. The ideal ... candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing strategies. This role requires a strong… more
- Elevance Health (Latham, NY)
- ** Medicare Risk Adjustment Advanced Analytics Consultant** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,** ... unless an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics Consultant** is responsible for employing advanced… more
- Centene Corporation (Bronx, NY)
- …access to health insurance, by providing education and assistance to Medicare individuals. Distribute health education materials and arrange for health screenings. ... prospective enrollees and determine eligibility for participation in the Advantage Medicare product + Understand and apply all policies and procedures pertaining… more
- Molina Healthcare (Albany, NY)
- …gains, audit readiness, and measurable member-experience improvements. You'll begin as a senior individual contributor with the charter to build a focused CTM ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more