Health Plan Sr. BA - New York

We are looking for a Health Plan Liaison to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model. · In this role, you will need to be an expert in healthcare. We are int ...

The Product Specialist supports the development and execution of product vision and strategy for Medicaid and Medicare products at VNS Health Plans.They analyze data related to business initiatives, manage strategic projects, identify opportunities for improvement in workflows an ...

The Finance Director will serve as a key partner supporting the financial performance and operational transformation of VNS Health Plans. · Lead financial analysis of affordability and medical cost initiatives within the Medicare Advantage product. · Evaluate the financial impact ...

We are seeking an exceptional Vice President of Health Plan Sales to join our Revenue team. This person will expand our sales processes with health plans nationwide and to contribute to the development of innovative partnerships. · Develop and oversee Garner's distribution model ...

Mending is seeking a hungry, detail-oriented individual to support the operational backbone of our health plans. · Support day-to-day vendor relationships across our TPA, utilization management vendor, network partners, · & other operational vendors—including meeting coordination ...

We are building a healthcare system that makes sense, starting by redefining the role of health insurance – one that focuses on reducing friction for doctors and patients, and investing in ways to create more meaningful doctor-patient relationships. · ...

We are seeking a Bilingual Health Plan Business Analyst with strong experience in Medicare Advantage and health plan operations.This role will focus on analyzing operational processes and building and documenting SOPs that support compliant, efficient health plan operations. · ...

We are seeking a Bilingual Health Plan Business Analyst with strong experience in Medicare Advantage and health plan operations. · Analyze and improve health plan operational processes · Develop, document, and maintain SOPs across operations (e.g., enrollment, claims, provider op ...

The Finance Director will serve as a key partner supporting the financial performance and operational transformation of VNS Health Plans. · Serve as a key finance representative on cross-functional initiatives aimed at improving operational performance. · Lead and influence colla ...

We are seeking a Spanish speaking Bilingual Health Plan Business Analyst with strong experience in Medicare Advantage and health plan operations. · ...

Garner's mission is to transform the healthcare economy delivering high-quality and affordable care for all. We are fundamentally reimagining how healthcare works in the U.S. by partnering with employers to redesign healthcare benefits using clear incentives and powerful data-dri ...

About Ash · Ash delivers the infrastructure that health plans and digital health organizations need to offer at-home testing programs that close care gaps, improve quality performance, and drive population health outcomes. Our clinical-grade, white-label platform ensures members ...

The Product Specialist supports product management team in developing benefit analysis. · Supports product management team in developing benefit analysis. · ...

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. · The Health and Recovery Plan (HARP) Care Manager develops, facilitates, and communicates a plan of care in partnership with the member, · their assigned Health Home, primary caregiver, · ...

MetroPlusHealth busca un Health and Recovery Plan (HARP) Care Manager para desarrollar planes de cuidado en colaboración con los miembros, sus asignados Health Home, principales cuidadores e internos. El HARP care manager evalúa las necesidades del miembro para brindar servicios ...

The Health and Recovery Plan (HARP) Care Manager develops facilitates communicates a plan of care in partnership with the member their assigned Health Home primary caregiver the primary attending physicians various Behavioral Health Substance Use Disorder providers. · Clinically ...

Job Description · Employees for this role can reside in NY or the surrounding states**** · Job Summary · Provides subject matter expertise and leadership for health plan provider network complex contracting activities. Supports network strategy and development with respect to ade ...

+MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. · +Clinically assess members for acute behavioral and physical health needs. · Conduct Utilization Review for designated Case Management members for some diversionary levels of care. · + ...

JOB DESCRIPTION · ***Employees for this role can reside in NY or the surrounding states**** · Job Summary · Provides subject matter expertise and leadership for health plan provider network complex contracting activities. Supports network strategy and development with respect to ...

Oversees the development implementation and management of compliance activities and enforcement for all VNS Health Health Plans insurance plans and products in accordance with NYS DOH and CMS requirements. · ...