• Director , Operational

    Molina Healthcare (Yonkers, 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 (07/13/25)
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  • Senior Analyst, Operational Regulatory…

    Molina Healthcare (Yonkers, 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 (Yonkers, 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 (Yonkers, 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 (Yonkers, 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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  • Marketing Director - Direct Mail, CRM,…

    WTW (Fort Lee, NJ)
    …insurance brands in the US This role requires both strategic vision and operational management, with direct oversight of campaign planning, optimization, and ... leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental… more
    WTW (07/10/25)
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  • Billing Director -Patient Financial…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Billing Director -Patient Financial Services- Corporate (ON SITE) Full-Time -Days** Responsible for direction and management responsibility over ... the business and operational activities of a department or medical care unit....training materials and train employees when necessary. + Provides oversight to management staff to ensure compliance with established… more
    Mount Sinai Health System (08/09/25)
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  • Director of Patient Services, Homecare RN…

    The New Jewish Home (Bronx, NY)
    …The HAPI Division of The New Jewish Home is seeking for a full time Director of Patient Care to join our team. Job Summary: Oversees all clinical operations, ... of quality metrics to support performance improvement initiatives and quality/compliance oversight . o Serves as quality subject matter expert with other stakeholders… more
    The New Jewish Home (06/25/25)
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