- 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
- 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
- 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
- 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
- Intermountain Health (Albany, NY)
- …of value-based care by Intermountain Healthcare to appropriate populations. It ensures compliance and accurate submission of publicly reported data for all payers. ... with ICD-10-CM and Official Coding Guidelines as determined by Centers for Medicare and Medicaid Services (CMS), National Center for Health Statistics (NCHS), US… more
- Molina Healthcare (Albany, 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 (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