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  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #266
    Tuesday, December 10, 2019
    Summary:Installs desktop hardware and software and performs routine equipment maintenance. Works closely with end users as well as senior and executive level leadership to provide support and resolve software/hardware problems. Logs all incidents and troubleshooting details in the incident tracking software. Maintains desktop asset records and assists with the equipment procurement process. Participates in implementation of desktop PC upgrades and related corporate projects. Maintains the compan ... More
  • Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA
    Req #424
    Tuesday, December 10, 2019
    This position is a critical role within MVP, supporting the successful transition of our participating providers to Value-Based Payment (VBP) and the achievement of the triple aim. PHMP professionals will be assigned to support the Regional VBP Leaders and the management of relationships and VBP contracting efforts with MVP’s strategic provider network partners in order to realize quality goals; support care coordination of patients; address social determinants of health; support integration of ... More
  • Burlington Office, 62 Merchants Row, Williston, VT, USA
    Req #420
    Monday, December 9, 2019
    Professional, Sales Rep - Medicare   Status: Full-time, Exempt: Yes  SUMMARY: Conduct all phases of selling including identify, qualify and meet with prospective clients located in the lower Vermont region (Bennington, Windam, Rutland, Windsor, Orange, Addison and Washington County) for purposes of presenting Medicare Advantage (MA) products  and services to meet company and individual enrollment goals. Assure understanding level  of each enrollee  by providing clear,  complete and accurate info ... More
  • Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #421
    Monday, December 9, 2019
    Associate, Member Services, Care Center RepresentativeStatus: Full-time, Exempt: No This position is responsible for addressing member/subscriber/provider inquiries, questions and concerns in areas including enrollment, claims, benefit interpretation, and referrals/ authorizations. Most of your day will be spent making contact by telephone.  Also may have some in-office contact and written correspondence/ e-mail with our customers as needed. Representatives may handle a variety of insurance type ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #412
    Monday, December 9, 2019
    Leader, Field Operations  Summary:     Responsible for outreach and promotion of MVP lines of business to individuals and community groups from target market. Supervises diverse team of outreach representatives. Ensure that the Team’s productivity meets projected targets. Works closely with the Department of Social Services staff and the staff of affiliated Health Centers. Assist the Retail Outreach Manager in implementing the regional team strategy.   Perform annual performance evaluatio ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #415
    Thursday, December 5, 2019
    Status: Full-time, Exempt: Yes This position manages the Accounting, Statutory Reporting, and Accounts Payable departments. Primary responsibilities include monthly GAAP & quarterly STAT financial statement reporting processes. This position will review and signoff on journal entries and reconciliations. It will provide guidance and oversight for the consolidation and financial statement preparation on a monthly basis as well as quarterly for the NAIC statements, NY Supplement filings, MMCOR, ... More
  • 625 State St, Schenectady, NY 12305, USA
    Req #386
    Tuesday, December 3, 2019
    This position is a critical part of this transformation. As a member of a Scrum team, this role is primarily responsible for that ensuring quality products are delivered to the organization. The candidate will work with a cross-functional team to understand business requirements and break them into user stories, develop test plans, test cases and execute test scenarios to ensure we are delivering high quality code. The ideal candidate is a highly motivated, self-starter who is passionate about q ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #411
    Tuesday, December 3, 2019
    Professional, Actuarial  Summary:This role will provide support to the company in performing necessary day-to-day Actuarial tasks. Assistsin premium rate development for MVP’s blocks of business. Develops, refreshes and analyzes financialforecasts and projections. Reviews actuarial models used to project future claim liabilities. Works toanalyze MVP’s financial statements. Analyzes and refines current methodologies used for premium ratedevelopment and reserving. Performs other duties as assigned ... More
  • Fishkill Office, 300 Westage Business Center Drive, Fishkill, NY, USA
    Req #405
    Monday, December 2, 2019
    Network Contracting MH, Professional, Network and Contract Analyst_BTarrytown, NY or Fishkill, NY (Note: The individual can work in either location as this position permits a home office/remote position)    This position supports the contracting team that negotiates and manages contractual arrangements with the health plan’s participating hospitals, hospital systems, and certain medical groups. Responsible for the logistics of provider contract process, including contract language and rate updat ... More
  • Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #417
    Monday, December 2, 2019
    Status: Full-time, Exempt: No This position is responsible for addressing member/subscriber/provider inquiries, questions and concerns in areas including enrollment, claims, benefit interpretation, and referrals/ authorizations. Most of your day will be spent making contact by telephone.  Also may have some in-office contact and written correspondence/ e-mail with our customers as needed. Representatives may handle a variety of insurance types including HMO, POS, PPO, ASO, Indemnity, NY and VT E ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #418
    Monday, December 2, 2019
    Professional, Mktg & Comm, Medicare  SUMMARY:   MVP Health Care is seeking an experienced Marketing &Communications professional to join our team. We are looking for anenthusiastic, creative and driven individual to provide marketing andcommunication expertise to the business. The ideal candidate will need to havea strong understanding of traditional and digital marketing tactics with provenproject management skills. You will: Partner in the planning, development and implementation of the go-to- ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #391
    Tuesday, November 26, 2019
    Associate, Credentialing Specialist   Summary: Conducts verification of and processes credentialing and recredentialing applications of providers and organizational facilities in accordance with MVP Policies, NCQA standards, CMS, NYS Department of Health and other regulatory agencies. Processes Credentialing and Recredentialing Applications for practitioners and organizational providers including preparing files for the MVP Credentials Committee. Conducts primary source verifications from ... More
  • Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA
    Req #409
    Tuesday, November 26, 2019
    Associate, Care Center Representative Medicaid    SUMMARY:Provides optimum customer service as required to maintain existing members and prevent cancellations. The Care Center Representative must take full responsibility for every call to ensurecallers concerns are met. Provides world class customer care to internal and external customers while consistently adhering to all call handling objectives, i.e. hold time, talk time, after call work, schedule adhere and quality assurance. Correctly respo ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA; Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA
    Req #413
    Friday, November 22, 2019
    Status: Full-time, Exempt: Yes    This role will, along with internal and external stakeholders, assess the clinical and service needs of MVP members with Behavioral Health (BH) needs. This candidate will coordinate the work of multiple subcommittees whose charge is to develop, to implement, to evaluate and to report on various quality interventions/programs intended to optimize clinical quality, maximize safe clinical practices and enhance services for adult and HARP populations, as well ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA; Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA
    Req #213
    Friday, November 22, 2019
    Status: Full-time, Exempt: YesObtain and analyze monthly data required for NCQA standards, HEDIS/QARR measures and CMS Star quality ratings. Interpret these findings, identify barriers, andpropose methods for improvement. Develop documentation and reporting tools toallow QI to track the progress and success of our outreach and interventions at both the member and provider level. Perform as an active member of all quality meetings that pertain to increasing quality results for members with both p ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #381
    Thursday, November 21, 2019
    Develop and maintain relationships within assigned book of business consisting of key accounts of varying sizes and funding arrangements. Apply consultative sales knowledge to ensure membership retention, identify opportunities for membership growth, and sell additional products and services to maintain and grow revenue. Coordinate day to day account activity, including strategic plan development and execution. Apply delegation skills to ensure accurate product and service delivery as well as ti ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #407
    Wednesday, November 20, 2019
    Status: Full-time, Exempt Summary: This role is responsible for developing reports and analysis for consumption by internal and external department customers using a variety of company data sources in support of the information requirements for the Operations Department including Claims, Member services, and Managed Care Systems areas. Presents and explains results of analyses internally and externally. Architect, design, implement, and support a platform providing secured access to large datase ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #402
    Wednesday, November 20, 2019
    Status: Full-time, Non-Exempt Summary:Monitors and records the quality of work performed by units within theOperations Department for claims processing and/or member eligibilitytransactions, for all regions in all lines of business that are pulled on adaily basis. Identify trends in specific errors and error rates. Determines andrecommends needs for retraining, or clarification of work procedures. Developsand produces, periodic reports based on audits/projects completed, for the QualityControl L ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #406
    Tuesday, November 19, 2019
    This position works as part of an integrated team designed to provide cross-functionalcommunication and marketing expertise to the business with a focus on the Commercial line of business.  Overall team objectives include but are not limited to: identifying, developing, and utilizing the most appropriate communication vehicle(s) to reach the targeted audience; create, plan, and provide communication solutions designed to help retain existing members and acquire new membership; and to use commu ... More
  • Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #399
    Tuesday, November 12, 2019
    Professional, Behavioral HealthJob Summary  This position makes triage and referral decisions requiring clinical judgement.   The individuals will follow members for mental health, substance abuse and co-morbid medical disorders according to the benefit guidelines and policies across the continuum of care.  The individual will review all requests for inpatient services in view of the Appropriate BH and MVP standards, such as Interqual and LOCADTR guidelines, assuring that appropriate follow up ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #384
    Friday, November 8, 2019
    Status: Full-time, Exempt          Summary: This position supports the Leader of Operational support in facilitating, fostering and driving a sophisticated level of engagement activities and core competencies for both internal and external customers of MVP’s Claims department with outcome measures that focus on the member and provider experience. The role will provide oversight and direction in the duties of monitoring attendance, personnel issues, ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #382
    Friday, November 1, 2019
    This is a great opportunity to join a fast-paced and collaborative HR team focused on supporting the organization attract, hire, retain and develop the best talent in the region.  The Professional, Talent Acquisition is responsible for the recruitment of a qualified and diverse pool of candidates for assigned departments. Provides support and guidance to hiring managers in the sourcing, selection and hiring process. Partners with assigned departments to provide support and guidance regarding t ... More
  • Fishkill Office, 300 Westage Business Center Drive, Fishkill, NY, USA
    Req #369
    Thursday, October 31, 2019
        Summary: The Outreach Representative conducts individual and group Field Outreach activities throughout their regions; promotes MVP throughout their regions, and conducts public presentations on MVP products. The Outreach Representative must provide fair and impartial information to individual Marketplace customers regarding coverage options available through the NY State of Health Marketplace. They help facilitate enrollment in Qualified Health Plans (QHPs), insura ... More
  • Utica Office, 419-421 Broad Street, Utica, NY, USA
    Req #359
    Thursday, October 31, 2019
    Associate, Outreach Representative    Summary: The Outreach Representative conducts individual and group Field Outreach activities throughout their regions; promotes MVP throughout their regions, and conducts public presentations on MVP products. The Outreach Representative must provide fair and impartial information to individual Marketplace customers regarding coverage options available through the NY State of Health Marketplace. They help facilitate enrollment in Qualified ... More
  • Fishkill Office, 300 Westage Business Center Drive, Fishkill, NY, USA
    Req #374
    Wednesday, October 30, 2019
    Associate, Provider Based Outreach Representative   The Outreach Representative conducts provider Based Field Outreach activities throughout their regions; promotes MVP throughout their regions, and conducts public presentations on MVP products. The Outreach Representative must provide fair and impartial information to individual Marketplace customers regarding coverage options available through the NY State of Health Marketplace. They help facilitate enrollment in Qualified Health Plans (QHPs) ... More