Job Search
-
625 State St, Schenectady, NY 12305, USA ● Rochester, NY, USA ● Req #2056Tuesday, June 4, 2024Status: Full-time, Non-Exempt Under the direction of the Appeals Manager: Thoroughly investigates and resolves member appeals and CTM’s in a professional and timely manner following departmental and company processes and within time limits set forth by CMS guidelines. Monitors appeals for trends and potential service improvement opportunities. Duties include: Investigates each appeal by gathering pertinent information from members, providers, facilities and internal resources in order to respo ...Read more about Member Appeals Associate, Medicare Appeal CoordinatorMore
-
220 Alexander St, Rochester, NY 14607, USA ● 625 State St, Schenectady, NY 12305, USA ● Req #2050Monday, June 3, 2024Status: Full Time, Exempt As a mission driven, community-based organization, MVP Health Care strives to create healthier communities. The Health Promotion and Program Analytics professional plays an integral role within the Health Promotion team by supporting the planning, implementation, and evaluation of both worksite and community well-being programs across MVP’s footprint for all lines of business. The professional will be responsible for applying evidence-based best practices towards the ...Read more about Professional, Health Promotion and Program AnalyticsMore
-
Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 20 S. Clinton Ave, Rochester, NY, USA ● Req #1986Tuesday, April 30, 2024Professional SME responsible for supporting the comprehensive data reporting and analytical needs for Run the Business support across the various Departments in the organization. Professional will partner with Digital SMEs to build new foundational data models bringing together disparate data sources to solve the business reporting need in a more efficient, powerful and flexible business intelligence way. Professional will also support Digital and other Teams as needed as business analyst SMEs ...Read more about Business Intelligence AnalystMore
-
Headquarters Office, 625 State Street, Schenectady, NY, USA ● Req #1911Wednesday, April 24, 2024Are you willing to be in the community, developing relationships to foster MVP growth? Do you understand customer unmet needs and how to differentiate product offerings? Are you an impact-oriented, collaborative leader who learns quickly, embraces change, and can see around corners? Do you have a knack for asking the right questions and holding others accountable? If you are a persuasive problem-solver with a strong sense of urgency and a desire to make an impact, then this position may be p ...Read more about Vice President Government ProgramsMore
-
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 ● Virtual ● Req #1932Thursday, April 18, 2024The Actuary will support the functions/tasks of the Actuarial Department in a more advanced and independent capacity. The functions include any of the following: premium rate development and regulatory filings, financial forecasting, experience studies, monthly reserve setting, provider risk sharing analytics/contracting, model development and other duties as assigned. The Actuary will be proficient in use and knowledge of large databases, Datamarts advanced excel modeling, SQL coding a ...Read more about Actuary AnalystMore
-
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