- Humana (Albany, NY)
- …will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new states. The business … more
- Highmark Health (Albany, NY)
- …on cross-functional efforts, in this role the incumbent should also act as a business data subject matter expert hands on where possible, and guide, lead and educate ... to: involved in hiring and termination decisions, coaching and development , rewards and recognition, performance management and staff productivity.Plan, organize,… more
- HealthEdge Software Inc (Albany, NY)
- …issues and client impacts. + Partner withappropriate Source Teams(BA, PM, Development , Account Management, Sales/ Business Development , Product, Content, ... Medicaid , and commercial), payment integrity, and healthcare plan operations (eg, claim life cycle/workflow, network contracting, payment/policy configuration,… more
- New York State Civil Service (Albany, NY)
- …the Medicaid Transformation program. * Directs and coordinates the development and implementation of policies, procedures, and internal controls to support the ... the Medicaid Transformation program. * Directs and oversees the development and implementation of data sharing agreements, forms, documents, processes and… more
- The Wesley Community (Saratoga Springs, NY)
- …oral reports/recommendations to the Resident Financial Services Manager about office operations and accounting procedures. + Assist in standardizing the methods in ... which will be accomplished. + Maintain Business Office files as they pertain to your position....complete. + Produce, review and mail monthly private pay/resident income/ Medicaid Pending statements for Wesley and Woodlawn + Follow… more
- Humana (Albany, NY)
- …to value. + Align scope of work with roadmap for new VBP model development to ensure compliance with Medicaid contractual requirements and RFP commitments. + ... financial terms, which align with segment goals. + Design and contribute to development of provider reporting packages to help providers understand their overall and… more
- Mathematica (Albany, NY)
- …and family support to nutrition, employment, disability, and international development . Mathematica offers our employees competitive salaries, and a comprehensive ... improving state Home- and community-based services within the state's Medicaid or HCBS administrative agencies such as health, human...consulting services to state and local clients, support the development of new health policies, assist with the … more
- Humana (Albany, NY)
- …priorities on a regular basis. + Embrace a service mentality to collaborate with Operations , Business Intelligence teams, Database teams, and IT to assure data ... our caring community and help us put health first** The Associate Director, Business Intelligence for CPSS Data and Analytics will support the account services,… more
- Mathematica (Albany, NY)
- …to the collection and interpretation of quantitative and qualitative data * Direct business development efforts and lead proposals for new projects * Author ... and family support to nutrition, employment, disability, and international development . Mathematica offers our employees competitive salaries, and a comprehensive… more
- Humana (Albany, NY)
- …will be responsible for leading the beginning-to-end operational support of specialty Medicaid value based payment (VBP) models in alignment with segment strategy ... + Analyze utilization data to reconcile provider disputes + Contribute to development and support of provider reporting packages to help providers understand their… more
- Mathematica (Albany, NY)
- …and family support to nutrition, employment, disability, and international development . Mathematica offers our employees competitive salaries, and a comprehensive ... improving state behavioral health programs within or in conjunction with Medicaid programs and state, local, and private providers. Experience managing public… more
- Humana (Albany, NY)
- …+ 2+ years of project leadership and consulting experience. + Health Care Business Domains - Medicare, Medicaid , Group, Specialty etc. **Additional Information** ... help us put health first** Are you interested in leveraging technology and business strategy to deliver improved member experiences and health outcomes to Humana's… more
- Humana (Albany, NY)
- …**Preferred Qualifications** + Medicaid knowledge, including experience with interpreting Medicaid contracts. + Operations content design and facilitation + ... work experience. + 3+ years of instructional design, training and learning development experience + Expert level experience with the Articulate 360 suite +… more
- Humana (Albany, NY)
- …+ Advanced certifications in software and/or process improvement + Experience with Medicaid + Experience in provider networks/provider operations + Advanced ... Adequacy tests the overall network in each county of operations to ensure the network is strong enough to...matching program + Network Resource Groups (NRGs) + Career development opportunities **Use your skills to make an impact**… more
- Humana (Albany, NY)
- …to assigned business partners + Conduct periodic compliance reviews of business partner operations + Develop and monitor metrics and other oversight ... focusing on marketing, agents, sales, as well as product offerings, development , and filings. The Senior Compliance Professional works assignments involving… more
- CDPHP (Albany, NY)
- …audit controls to ensure traceability. QUALIFICATIONS: + Minimum five (5) years configuration, business or IT operations , project management, or business ... system configuration, configuration design, preparing detailed specifications for the development of business configuration and testing, implementing… more
- Humana (Albany, NY)
- …is a multi-disciplinary team focused on creating data-driven strategies to transform our business and the experiences we create for our members, provider partners & ... associates. We partner closely with our operations counterparts, working hand-in-hand to translate these strategies into...are curious - you enjoy connecting the dots between business metrics and frontline, understanding key root causes for… more
- Cardinal Health (Albany, NY)
- …legal advice and services in order to protect the organization's assets, operations and image. This function provides legal counsel related to commercial, corporate ... all company legal matters, manages outside counsel and manages legal operations . Commercial Transaction provides legal advice, counsel and services to domestic… more
- Humana (Albany, NY)
- …and tools such as: user research and concept testing, opportunity sizing and business case development , product blueprints, training development and ability ... not limited to: user research and concept testing, opportunity sizing and/or business case development , product blueprints, data and/or technology requirements,… more
- Humana (Albany, NY)
- …management, operations , and technology/product delivery + Experience in Systems Development Life Cycle, Waterfall, and Agile Development Methodologies + ... (ie, both Traditional and Generative Artificial Intelligence) + Experience in IT business analysis, including artifacts development + Experience problem solving… more