- Molina Healthcare (Yonkers, NY)
- …ongoing development and implementation of policies and procedures that guide and support the provision of medical staff services. Maintains a working knowledge of ... License without restrictions (free of sanctions from Medicaid or Medicare ) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare… more
- Molina Healthcare (Albany, NY)
- …architecting and maintaining robust, scalable, and secure data pipelines that support critical decision-making across the organization. This position requires deep ... * Architect and implement scalable, high-performance Big Data solutions that support structured and unstructured data from diverse sources. * Build and… more
- Molina Healthcare (Buffalo, NY)
- …areas of responsibility + Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple ... + Ability and willingness to take a hands-on execution role where required to support client needs and team development + Highly organized with an ability to work… more
- Arnot Health (Elmira, NY)
- …9. Completes various government and employee requested forms such as medical support notices, Medicare verifications, and DSS requests. 10. Responsible for ... stakeholders on leave statuses as necessary. 13. Manages vendor relationships in support of employee benefit and retirement plans and programs. 14. Preserves… more
- CenterWell (Albany, NY)
- …Owner to lead the delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- CVS Health (Albany, NY)
- …Network; Examples include ensuring data standards are synchronized across Medicaid and Medicare platforms, ensuring duals workflows are support across systems, ... experience in strategy and delivery leadership roles + 5+ years of Medicare /Medicaid and/or Duals experience + Proven success navigating large scale cross functional… more
- Humana (Albany, NY)
- …necessary to support optimal value based care in accordance with Medicare and Humana policy. The Medical Director will collaborate with clinicians and ... Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical...support optimal value based care in accordance with Medicare and Humana policy. **Use your skills to make… more
- Humana (Albany, NY)
- …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to ... contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana… more
- Molina Healthcare (Syracuse, NY)
- **Job Description** **Job Summary** Provides leadership to the Medicare Duals team and plays a critical role in advancing the Medicare Integrated Duals segment ... strategic priorities. Develops and executes Medicare strategies, including state-specific and product-specific growth initiatives. Leads high-priority projects… more
- New York State Civil Service (New Hampton, NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). ... appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a...unique attributes and skills are valued and utilized to support the mission of the Agency. OMH is an… more