- Molina Healthcare (Albany, 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)
- …Duals Center of Excellence, clinical, compliance, analytics and network teams, the Senior Manager drives innovation and operational excellence to optimize member ... lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans (D-SNP). This… more
- CVS Health (Albany, NY)
- …and more compassionate. And we do it all with heart, each and every day. As a Senior Manager within the Aetna Medicare Pharmacy team, you will play a ... critical role in shaping and executing the organization's Medicare Part D formulary and product strategy. Leveraging your...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Albany, NY)
- …we do it all with heart, each and every day. **Position Summary** As a Senior Legal Counsel, Pharmacy Benefit Manager (PBM) you will provide legal guidance, ... advice and recommendations for action to internal stakeholders and senior /executive management regarding federal/state regulations in the healthcare industry. Serves… more
- Trinity Health (Latham, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** RN Care Manager - Full Time - Eddy SeniorCare (Latham) Eddy SeniorCare has a rewarding ... opportunity for an RN Case Manager to work out of our 385 Watervliet Shaker...Watervliet Shaker Road, Latham location! PACE is a unique program on the forefront of trends in healthcare, combining… more
- CVS Health (Albany, NY)
- …for the strategic alignment, operational success and performance management of Medicare Advantage Value-Based Contracts (VBC), by ensuring that VBC arrangements ... with others to meet/exceed expectations **Preferred Qualifications** + Experience in Medicare Advantage and/or Value Based Contracting + Ability to remain flexible… more
- CVS Health (Albany, NY)
- …individual will play an instrumental role in helping to strengthen our Medicare Telesales organization. Our Technology Implementation Manager will be responsible ... for coordinating and implementing all initiatives through end-to-end program oversight across DTC Sales operations technology. The Operations Technology Project … more
- Humana (Albany, NY)
- …Experience Platform (AEP) and Next Best Action (NBA) execution to join the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Our… more
- CVS Health (Albany, NY)
- …Ensures compliance with contractual requirements. Coordinates and collaborates with program integrity staff, compliance, and senior leadership. Contributes ... A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / ...Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and… more
- CenterWell (Albany, NY)
- …of our caring community and help us put health first** The Program leader, Provider Education builds strategies for development, engagement, best clinical practices ... and processes for clinical community within the enterprise. The Program leader, Provider Education requires a solid understanding of how organization capabilities… 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
- CVS Health (Albany, NY)
- …is an integral part of the Medicare Stars business. We are seeking a ** Senior Manager , Business Analysis** , to join our team. This team manages data ... environments, reporting and web applications that support Medicare and Stars-specific initiatives. **This position will include:** +...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Albany, NY)
- …the delivery of high quality care to the Medicare population. As a Senior Product Manager , you will be responsible for driving the strategic direction of ... a core part of our platform. Through partnership with senior business and engineering leaders, you will oversee the...experience **Preferred Qualifications** 4+ years operating in a Product Manager role (or similar) MA / MBA in any… more
- CenterWell (Albany, NY)
- …is not guaranteed. There also may be opportunity to cover other aspect of the program , such as covering PTO for APPs in CenterWell Medical group (phase 1). There are ... **Knowledge of HEDIS measures and quality indicators** **Experience managing Medicare Advantage panel of patients with understanding of Best Practice… more