- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and ... provider training and education, in alignment with Molina Healthcare's...compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact… more
- Evolent (Albany, NY)
- …SOUTHWEST REGION We are seeking a strategic and collaborative Associate Director, Provider Engagement to lead our oncology-focused provider engagement and ... practice transformation efforts in the **New Mexico** . Reporting to the National Provider Engagement Sr. Director, you will be responsible for building and managing… more
- Datavant (New York, NY)
- …experiences to realize our bold vision for healthcare. The Vice President of Growth, Provider GTM will lead growth initiatives for Datavant's Provider GTM team, ... focusing on identifying potential customers within the provider space and penetrating new departments in current clients. This role combines strategic vision and… more
- Molina Healthcare (NY)
- …Description** **Job Summary** Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains ... critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and...to each database. Validate data to be housed on provider databases and ensure adherence to business and system… more
- Sharecare (Albany, NY)
- …for everyone. To learn more, visit www.sharecare.com. **Job Summary:** Sharecare Provider Solutions is the leader in providing secure electronic exchange, delivery ... to thousands of Healthcare Providers across the United States. Provider Solutions provides unmatched compliance in the industry with...getting reviewed prior to release 100% of the time. Provider Solutions is looking for a strong, dynamic and… more
- Elevance Health (Latham, NY)
- …accommodation is granted as required by law_ The Network Services and Programs, Provider Network Mgr develops the provider network through contract negotiations ... providers in areas with increased competition or where greater provider education around managed care concepts is required. +...or any combination of education and experience, which would provide an equivalent background. + Travels to worksite and… more
- Cognizant (Albany, NY)
- ** Provider Appeals & Grievances Specialist** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We are ... seeking a dedicated Provider Appeals & Grievance Specialist with 1 to 2...be responsible for the research and resolution of Medicaid provider appeals that will involve research of member benefits,… more
- Healthfirst (NY)
- …and management to lead and support a workforce in the areas of provider lifecycle management, including provider contracting, provider data management, ... strategic plans to ensure modern and efficient claims management and provider payment + Analyzes, evaluates, develops, and leads implementation of strategic… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Housing is not provided as part of our program. Essential Accountabilities: + The Provider Relations intern will be responsible for partnering with our provider ... clinical trainers on researching content development for new provider trainings. + Assisting in provider outreach calls. ie DSNP Model of Care Trainings required… more
- Molina Healthcare (Rochester, NY)
- **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, ... claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. + This role is involved in… more