- Molina Healthcare (NY)
- …major projects of considerable complexity, prepares system design specifications, conducts research to resolve customer initiated issues related to core systems ... project teams in the development of large multi-system, multi-platform projects. This position is responsible for implementing the test approach, strategy for test… more
- Molina Healthcare (Syracuse, NY)
- …or discrepancies related to over- or underpayment. + Utilize QNXT to research claims history, provider contract setup, and benefits configuration. + Work ... + Assist manager in establishing peer review standards and methodology + Research and review new audit tools and techniques and provide recommendations to… more
- Molina Healthcare (NY)
- …who have Databricks experience with advanced skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, ... + Converting data into usable information that is easy to understand. + Research and develop reports and analysis for senior management and effectively communicate… more
- Molina Healthcare (NY)
- …appeal into information system and prepares documentation for further review. + Research issues utilizing systems and other available resources. + Assures timeliness ... medical records, notes, and/or detailed bills as appropriate to assist with research . + Determines appropriate language for letters and prepare responses to appeals… more
- Molina Healthcare (NY)
- …Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research , analysis and modeling of complex healthcare claims data, pharmacy ... understand and provides insights needed to support strategic investment decisions + Research and develop reports and analyses for senior management and effectively… more
- Binghamton University (Binghamton, NY)
- …Science and Industrial Engineering: The Watson College's SSIE is a leader in both research and education , generating $8.5-12 million annually in research ... faculty members at the rank of Assistant Professor. The positions will begin in Spring or Fall 2025 (2025-2026...field and support efforts to enhance diversity in both research and education . Job Requirements: The candidate… more
- Trinity Health (Syracuse, NY)
- …values areconsistent in practice and include patient advocacy, safety and education .Teamwork promotes clinical excellence and is rooted in effective communication, ... shared vision reflecting the mission, vision, and values of St. Joseph's. ** POSITION PURPOSE** Responsible for ensuring accurate CPT and/or ICD-10 documentation for… more
- Molina Healthcare (Buffalo, NY)
- …membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment ... coordinate with Center of Excellence team as needed. **Job Qualifications** **Required Education ** Bachelor's Degree or equivalent combination of education and… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** **Required Education ** Bachelor's Degree in Finance, Economics, Math, Computer Science; or… more
- Molina Healthcare (Syracuse, NY)
- …impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials. ... provided in accordance with all State/HMO requirements.. **Job Qualifications** **Required Education ** Bachelor's Degree in Social Work, Human Services or related… more