- Molina Healthcare (Rochester, NY)
- …laws and regulations pertaining to the Health Care environment **Job Duties** The Operational / Regulatory Oversight Sr. Analyst works with health plans and ... **Job Description** **Job Summary** Establish a specifically designed Operational Regulatory Oversight program that effectively...ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and… more
- Deloitte (Rochester, NY)
- AML Consultant-Project Delivery Senior Analyst - Regulatory , Risk & Forensic Operate Are you an experienced, passionate pioneer in technology who wants to ... a collaborative environment? As an experienced AML Project Delivery Senior Analyst you will have the ability...leading practice workflows, addressing deficits in quality, and driving operational outcomes The Team Our Deloitte Regulatory ,… more
- Molina Healthcare (Rochester, NY)
- **Job Description** **Job Summary** The Sr Analyst , Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, accurate, ... causes of issues that impact encounters and identify improvements to operational performance. **Job Duties** + Monitors inbound and outbound encounters submissions… more
- Molina Healthcare (Rochester, NY)
- …and technical issues. Ensures system configuration aligns with business rules, regulatory requirements, and operational needs. Supports upgrades, releases, and ... health plan implementations while validating data integrity and recommending improvements to enhance system efficiency and quality. **KNOWLEDGE/SKILLS/ABILITIES** + Serves as a subject matter expert (SME) on QNXT system capabilities, leveraging system… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: The Actuarial Analyst performs actuarial services in support of Health Plan operations and monitors and maintains financial solvency ... to establishing rates, rating structures and systems and reserves. The Actuarial Analyst has accountability to providing in depth analysis on the overall risk… more