• 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. ... support executive decision-making. + Research and develop reports and analysis for senior management; effectively communicate results. + Assist in the preparation of… more
    Molina Healthcare (07/25/25)
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  • Senior Medical Director ( Medicare )

    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 (06/13/25)
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  • Senior Encounter Data Management…

    Humana (Albany, NY)
    …that result from the data exchange between Humana and its trading partners, Medicare and Medicaid. The Senior Encounter Data Management Professional will work ... of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission… more
    Humana (08/15/25)
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  • Senior Healthcare Program Specialist…

    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
    Staffing Solutions Organization (07/23/25)
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  • Senior Manager, Product Mgt & Development…

    CVS Health (Albany, NY)
    …lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans (D-SNP). This ... Center of Excellence, clinical, compliance, analytics and network teams, the Senior Manager drives innovation and operational excellence to optimize member… more
    CVS Health (09/05/25)
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  • Senior Analyst, Operational Regulatory…

    Molina Healthcare (Syracuse, NY)
    …any identified finding; Supports management with presenting results and recommendations to Senior Leadership and department staff. * Recommends new or updated job ... or special projects as required. + Must have experience working in Medicare + Must have experience analyzing claims. **Job Qualifications** **REQUIRED EDUCATION:**… more
    Molina Healthcare (08/22/25)
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  • Audit & Reimbursement Senior

    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
    Elevance Health (09/09/25)
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  • Director, Medicare Segment Optimization

    Molina Healthcare (Rochester, NY)
    **Job Description** **Job Summary** Leads and directs Molina Medicare segment leaders who are responsible for the development and administration of Medicare ... for assigned markets, including D-SNP market performance management. + Function as Medicare subject matter expert and point of contact for assigned market. +… more
    Molina Healthcare (09/07/25)
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  • Health Care Disputes - Compliance Risk Adjustment,…

    Ankura (New York, NY)
    …accreditations, operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment. The Senior Director ... to complex litigation, enforcement, and regulatory challenges. Role Overview The Senior Director will support the Healthcare Payer team within Ankura's Disputes… more
    Ankura (09/09/25)
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  • Medicare Field Sales Representative

    MVP Health Care (Schenectady, NY)
    …staff, and other key stakeholders within the assigned territory. + Market Medicare products on-site at provider facilities, senior centers, community events, ... thinking and continuous improvement. To achieve this, we're looking for a ** Medicare Sales Representative** to join #TeamMVP. This is the opportunity for you… more
    MVP Health Care (09/05/25)
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