• Senior Representative, Provider Services

    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
    Molina Healthcare (08/28/25)
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  • Specialist, Provider Network Administration…

    Molina Healthcare (Rochester, NY)
    …**This role will have standard EST business hours.** **Job Summary** Provider Network Administration is responsible for the accurate and timely validation ... and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal… more
    Molina Healthcare (08/14/25)
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  • Manager, Provider Network Administration…

    Molina Healthcare (Buffalo, NY)
    **Job Description** **Job Summary** Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider ... system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. **Knowledge/Skills/Abilities**… more
    Molina Healthcare (08/13/25)
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  • Associate Director, Provider Engagement…

    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
    Evolent (07/25/25)
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  • Vice President, Provider Growth

    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
    Datavant (09/30/25)
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  • Director, Provider Data Management…

    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
    Molina Healthcare (09/27/25)
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  • Manager, Provider Sales - Remote

    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
    Sharecare (09/17/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Albany, NY)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer ... and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business… more
    Humana (09/09/25)
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  • Adjudicator, Provider Claims (LTSS Call…

    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
    Molina Healthcare (08/27/25)
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  • Provider Data Management & Credentialing…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Provider Data Management and Credentialing Specialist is responsible for ensuring the data integrity for contracted providers. This includes ... ongoing audit of the provider database, monitoring provider sanctions from regulatory agencies, participation status with payer programs, and other demographic… more
    Mount Sinai Health System (07/30/25)
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