• Director , Operational

    Molina Healthcare (Albany, NY)
    …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
    Molina Healthcare (07/29/25)
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  • Senior Analyst, Operational Regulatory…

    Molina Healthcare (Syracuse, NY)
    …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
    Molina Healthcare (08/22/25)
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  • Director , Medicare Segment…

    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 ... **Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function… more
    Molina Healthcare (09/07/25)
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  • Program Director - Medicare Duals…

    Molina Healthcare (NY)
    …abilities; ability to handle multiple priorities and deal with ambiguity; provide oversight over the strategic and operational portfolios; manage strategic ... Program Management professional. Responsible for overall governance across all operational and strategic portfolio of projects; strong management and leadership… more
    Molina Healthcare (08/22/25)
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  • Director , Provider Network Management…

    Molina Healthcare (Buffalo, NY)
    …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
    Molina Healthcare (08/20/25)
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  • Manager, Provider Engagement - VBP…

    Centene Corporation (Queens, NY)
    …is critical in managing end-to-end provider engagement, contract modeling, and performance oversight for Medicare Advantage and Dual Eligible Special Needs Plans ... incentive programs, attribution logic, and provider engagement strategies. + Represent Medicare VBP in governance discussions and escalate operational issues… more
    Centene Corporation (07/09/25)
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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 ... class and globally recognized independent experts who tailor financial, operational , and compliance solutions to complex litigation, enforcement, and regulatory… more
    Ankura (09/09/25)
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  • Director of Managed Care Contracting

    Stony Brook University (Commack, NY)
    Director of Managed Care Contracting **Position Summary** Stony Brook Medicine is seeking an experienced and strategic Director of Managed Care Contracting to ... Managed Care. This leadership role is responsible for the oversight , negotiation, and management of all Managed Care contracts...financial goals. Under the direct supervision of the Assistant Director of Managed Care, the Director will… more
    Stony Brook University (08/08/25)
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  • Director , Bureau of State Operated…

    New York State Civil Service (NY)
    NY HELP No Agency People With Developmental Disabilities, Office for Title Director , Bureau of State Operated Programs and Services Occupational Category Other ... Street Address TBD City TBD State NY Zip Code 00000 Duties Description The Director , Bureau of State Operated Programs and Services will serve at the executive level… more
    New York State Civil Service (09/03/25)
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  • Director , Financial Planning & Analysis…

    Humana (Albany, NY)
    …and other data to provide accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an ... **Become a part of our caring community and help us put health first** The Director , Financial Planning & Analysis analyzes and forecasts financial, economic,… more
    Humana (08/26/25)
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