- Molina Healthcare (Rochester, 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
- Molina Healthcare (Rochester, 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
- Molina Healthcare (Rochester, 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
- Excellus BlueCross BlueShield (Rochester, NY)
- …and display in all electronic mediums employed by the enterprise. The incumbent ensures compliance with federal and state regulations and BCBSA in delivery of key ... compliance documents including, but not limited to, Subscriber Contracts,...limited to, Subscriber Contracts, Summary of Benefits and Coverage, Medicare regulatory documents, and other customer notifications regarding product… more
- Molina Healthcare (Rochester, NY)
- …internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures ... external auditors for all formal Core Operations audits that are not compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research,… more
- Molina Healthcare (Rochester, 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