• Director , Operational

    Molina Healthcare (Yonkers, NY)
    …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve. ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
    Molina Healthcare (10/09/25)
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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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  • Medicare Segment Optimization…

    Molina Healthcare (NY)
    …**Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function ... as Medicare subject matter expert and point of contact for...drive compliance and performance objectives as well as provide oversight , including service level agreements. + Works with staff… more
    Molina Healthcare (09/07/25)
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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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  • Director , Provider Education

    Humana (Albany, NY)
    …part of our caring community and help us put health first** The Director , Provider Education develops and leads initiatives, strategies, and processes focused on ... enhancing provider knowledge of Medicare and Medicaid quality and risk-adjustment programs. They help...working in close collaboration with regional market teams. The Director , Provider Education is a key leader on the… more
    Humana (10/08/25)
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  • National Medical Director , Home-Based Care…

    CenterWell (Albany, NY)
    …improvement. + Work collaboratively with the Strategy Advancement and Operations Director to align clinical and operational priorities. **Quality Improvement ... and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical...skills; ability to collaborate effectively with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare more
    CenterWell (10/02/25)
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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 GRC & EPMO

    Softheon (New York, NY)
    Job Title: Director of GRC & EPMO Team: Finance Job Location: Remote, Up to 25% Travel About Us: Join us in revolutionizing healthcare! We build software that ... our health plan and government customers with the administration, reporting, and operational requirements of their plans. By tackling the complexities of enrollment,… more
    Softheon (10/07/25)
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  • Director , Appeals & Grievances (Remote)

    Molina Healthcare (Buffalo, NY)
    …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
    Molina Healthcare (09/26/25)
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  • Deputy Director Ddso 2, Bridge Deputy…

    New York State Civil Service (NY)
    NY HELP No Agency People With Developmental Disabilities, Office for Title Deputy Director DDSO 2, Bridge Deputy Director - Downstate Occupational Category Other ... and system level to serve as the Bridge Deputy Director of State Operations Office Region 5. The Bridge...but are not limited to: - Direct support and oversight to a range of staff across a variety… more
    New York State Civil Service (10/08/25)
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