- Novo Nordisk Inc. (Buffalo, NY)
- …current co-promotion partners. Internally, the CMCS I reports to the District Business Manager of the specific sales territory. The CMCS I also interacts and ... level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage… more
- Molina Healthcare (Rochester, NY)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (Albany, NY)
- …in new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products ... Medicare plans within the Market. + Direction of senior leaders of specific functional areas as assigned. Functional...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Centene Corporation (New York, NY)
- …teams to improve satisfaction and reduce disenrollment. + Partners with senior stakeholders to diagnose and address critical friction points. Lead cross-functional ... insights from member experience data, to influence the long-term experience strategy of Medicare . + Performs other duties as assigned. + Complies with all policies… more
- Humana (Albany, NY)
- …are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of ... motivate and train a team of sales individuals. The Senior Manager , Medicare Sales, must...+ This role is part of Humana's Driver safety program and therefore requires an individual to have a… more
- Project Renewal, Inc. (New York, NY)
- Title: Senior Manager , Compliance Program : Legal, Varick Headquarters Salary Range: $90,000 - $100,000 per year Overall Responsibilities: The Senior ... regulatory compliance in healthcare and related human services. The Senior Manager , Compliance reports to the Director...Medicare , Part 2). + Ensure the organization's compliance program meets FQHC and Article 28 standards. + Policy… more
- Danaher Corporation (New York, NY)
- …Business System (https://www.danaher.com/how-we-work/danaher-business-system) which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) ... customer engagement and responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the Value and Access… more
- Highmark Health (Buffalo, NY)
- …- Onsite 3 days a week. T, W. Th.** **This role is focused on the Medicare Advantage Stars program . This right candidate for this role will have a foundational ... knowledge of the Medicare Stars program .** **ESSENTIAL RESPONSIBILITIES** + Work...**Required** + 4 years of experience in a project manager role **Preferred** + PMP certification or equivalent training… more
- Elevance Health (East Syracuse, NY)
- …Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- Access: Supports For Living (Middletown, NY)
- …$26.44 per hour Hours: Monday-Friday 8:00AM-4:30PM (40hrs) Job Description: Reporting to the A/R Manager , the Senior Billing Specialist is a key position in the ... Senior Billing Specialist Location: Middletown, NY, United StatesDate...of weekly claims processing + Analyze, billing and processing program claims for accuracy and completeness; submit claims to… more
- CenterWell (Albany, NY)
- …part of our caring community and help us put health first** The Manager of Pre-Bill Audit provides strategic leadership and operational oversight for the ... in unbilled rates, revenue cycle performance, and compliance. The Manager leads a team of Pre-Bill Specialists, partners with... leads a team of Pre-Bill Specialists, partners with senior leadership, and champions initiatives that enable scale and… more
- Humana (Albany, NY)
- …advanced agentic AI decision-making across our organization. As a Lead Technical Product Manager (PM-T), you will be responsible for shaping the vision, defining the ... and meets regulatory requirements. + Communicate complex technical concepts to senior executives in a clear, results-oriented manner. + Work with compliance… more
- Nuvance Health (Rhinebeck, NY)
- …* Surgical Review Corporation (SRC) - Robotic Center of Excellence * Center for Medicare and Medicaid Services (CMS) - 5 Star Rating At Northern Dutchess Hospital, ... of our patients and each other's success. *Summary*: The Manager of Patient Experience performs a wide variety of...a variety of sources to assist with analysis and program development for a successful program . Responsible… more
- Blue Matter (New York, NY)
- …planning also spans diverse care settings with distinct market access dynamics. As a Manager with Blue Matter, you will join a startup firm with a dynamic and ... to help grow and build the company. You will work collaboratively with senior internal and client team members to address critical business issues in biotechnology… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …colleagues to produce/recommend/develop long-term plans. * Serves as Vendor Relationship Manager for appropriate health plan vendors. Provides support and expertise ... etc., in delivering solutions. * Ensures bid submissions for NYS Exchange and Medicare PBP participation are executed annually for the Health Plan to participate… more
- Trinity Health (Syracuse, NY)
- …across all areas of Acute Care Syracuse, partnering with unit and program managers and leaders as appropriate. + Leads organization pre-survey activities ... to evaluate the effectiveness of regulatory activities. + Strategizes with senior leadership to develop organizational response to new regulations and standards… more
- CenterWell (Albany, NY)
- …part of our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program … more
- CenterWell (Albany, NY)
- …CenterWell Medical Group, a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group will provide ... , a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group...the state. . Graduate of accredited MD or DO program of accredited university . Board certification or eligible… more
- CenterWell (Albany, NY)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF, ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel:… more
- CVS Health (Albany, NY)
- …improve outcomes, manage costs, and offer an unmatched experience for our patients. As a Senior Product Manager , you will be a key leader in our organization, ... have the needed support from specialist. You'll work with senior business and engineering leaders to lead a product...digital health solutions + 4+ years as a Product Manager + Experience with data analytics and core healthcare… more
