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Headquarters Office, 625 State Street, Schenectady, NY, USA ● Req #2153Thursday, September 5, 2024Qualifications you’ll bring: Bachelor's degree or equivalent education and work experience in a managed care, public health, or health care environment. MPH, MBA or other advanced degree preferred Minimum 5 years Health care / health insurance experience Minimum 2 years prior experience interpreting and evaluating regulatory policy and documentation Demonstrated ability to identify, interpret, and explain regulatory, policy, and other external developments and requirements via clear and con ...Read more about Government Programs AnalystMore
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Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 20 S. Clinton Ave, Rochester, NY, USA ● Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA ● Req #2173Wednesday, September 4, 2024Qualifications you’ll bring: Bachelor’s Degree Health Administration, Business, Economics, Health Informatics, or related field One year experience in a business or healthcare environment involving the analysis of financial or other large data sets. Masters’ Degree in relevant field may be considered in lieu of this experience Demonstrated problem-solving, analytical abilities, and ability to work independently with strong attention to detail, and written and verbal communication skills Inter ...Read more about Risk Adjustment AnalystMore
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220 Alexander St, Rochester, NY 14607, USA ● 303 S Broadway # 230, Tarrytown, NY 10591, USA ● 625 State St, Schenectady, NY 12305, USA ● Req #2152Tuesday, August 20, 2024Qualifications you’ll bring: Licensed Social Worker in NYS, with demonstrated clinical experience and previous experience working with the Medicaid population and case management experience required in long term services support. Must be able to solve problems while exhibiting clinical judgment and realistic understanding of the current environment. Previous experience required in situations demanding strict adherence to confidentiality. Must be able to make independent decisions about ap ...Read more about Social Worker, Medicaid Long Term Support ProgramMore
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Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 20 S. Clinton Ave, Rochester, NY, USA ● Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA ● Req #2154Monday, August 19, 2024Qualifications you’ll bring: Bachelor's degree of applicable study with minimum of 3 years of experience in Health Care Analytics Role or Advanced degree in math or statistics and at least 1 year of experience working with Health Care data Working knowledge of Provider Billing/Reimbursement methodologies Foundational knowledge of MVP's markets and products and awareness of competitive landscape Working knowledge of MVP Data assets including claim, pharmacy, member and provider data Proficiency ...Read more about Health Care Economics AnalystMore
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Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 20 S. Clinton Ave, Rochester, NY, USA ● Req #2122Monday, August 12, 2024Full-Time, Exempt Position is hybrid JOB SUMMARY: Responsible for financial recovery including recovery vendors and coordination of benefits for the organization. This role is responsible for leading all claims payment recovery activities, oversight and maintenance of all internal and vendor related workflows, all coordination of benefits activities. Accountable for the direction of recovery and collections programs identifying areas of opportunity for improvement. Partners with organizat ...Read more about Leader, Cost Containment and RecoveryMore
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Headquarters Office, 625 State Street, Schenectady, NY, USA ● Req #2121Wednesday, August 7, 2024Full-Time, Exempt SUMMARY: This position will utilize the essentials of an integrated Case Management model that includes assessment, planning, implementation, care coordination, monitoring and advocacy to meet the member’s comprehensive health needs. Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of designated members, act as a proactive partner to provide appropriate education, resources, and healthcare coaching. The principal role of the posi ...Read more about Professional, Case ManagerMore
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625 State St, Schenectady, NY 12305, USA ● Rochester, NY, USA ● Tarrytown, NY, USA ● Req #1769Tuesday, October 17, 2023Status: Full Time, ExemptThis position will utilize the essentials of an integrated utilization management and case management model that includes assessment, planning, implementation, care coordination, monitoring, and advocacy to meet the needs of medically complex Medicaid members. Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of designated members, act as a proactive partner, and provide appropriate education, coordination of care and resou ...Read more about Case Manager, Medicaid Long Term Support ProgramMore