- Molina Healthcare (Albany, NY)
- …supporting compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Compliance Analyst position is primarily responsible for Medicare Oversight. + ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... requirements development. + Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance, and compliance + Determine… more
- Highmark Health (Albany, NY)
- …:** **JOB SUMMARY** This job partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and/or ... trends, and/or contract changes. **ESSENTIAL RESPONSIBILITIES** + Manage and coordinate compliance related processes. + Monitor governance and compliance of… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting work assignments are varied and frequently require… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** This Actuarial Analyst 2 position is a part of the HealthCare Economics team focused on evaluating ... stakeholders and providing valuable input to the business. The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Actuarial Analyst 1 provides actuarial support across a broad range of actuarial and business needs ... for specific product lines. The Actuarial Analyst 1, General work assignments are often straightforward and of moderate complexity. The Actuarial Analyst 1 may… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Actuarial Analyst 2, Pricing is responsible for setting pricing assumptions, submitting bids, filing and ... maintains pricing tools that price standard and custom benefits. The Actuarial Analyst 2, Pricing work assignments are varied and frequently require interpretation… more
- Molina Healthcare (Albany, NY)
- **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and ... existing lines of business and expansion into new states. The Lead Analyst , Reimbursement will be primarily responsible for implementation, maintenance, and support… more
- Humana (Albany, NY)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root causes driving issues and developing solutions +… more
- Molina Healthcare (Albany, NY)
- **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting ... requirements into overall functional architecture for complex s/w solutions in compliance with industry regulations. *Provides subject matter expertise and reviews… more
- Molina Healthcare (Albany, NY)
- …+ Engages with operations leadership and Plan Support functions to review compliance -based issues for benefit planning purposes. **Recoveries & Disputes** + Review ... + Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). +… more
- Humana (Albany, NY)
- …strong selling and presentation skills (oral and written) + Healthcare and Medicare experience + Experience facilitating with mixed teams, and indirect matrix teams ... in Healthcare systems + Experience in user provisioning + EPIC analyst certification/accreditations as they related to business functions (utilization management,… more