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  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #386
    Tuesday, February 25, 2020
    Status: Full-time, Exempt: YesThe Quality Engineer is a critical part of this transformation.  As a member of a Scrum team, the Quality Engineer 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 ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #466
    Monday, February 24, 2020
    Status: Full-time, ExemptSummary: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 datasets ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA; Syracuse Office, 333 West Washington St, Syracuse, NY, USA
    Req #465
    Thursday, February 20, 2020
    Under the direction of the Leader, Commercial Product Development: Responsible for managing assigned products from the Commercial Product Portfolio.  Serves as the subject matter expert on products assigned including thorough analysis of all aspects of product performance, design, regulatory compliance, and market competitiveness.  Continuously works through established channels and processes to report product performance and make product recommendations to management including:  new ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #467
    Thursday, February 20, 2020
    Professional, Hospital Contract Program Manager, Network Contracting East/VT, Professional JOB SUMMARYResponsible for coordinating hospital and related professional and ancillary provider contract negotiation processes for the MVP East NY and VT regions, including: ·Negotiation of contract rates and terms for hospital and hospital system (related professional, and ancillary providers), including contract language and rates·Manage provider performance initiatives / programs - hospital and profes ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #464
    Tuesday, February 18, 2020
    The M&C team has a fast-paced, highly-collaborative, results-oriented environment, while contributing to the corporate growth goals.  This is a new position that affords the candidate an opportunity to contribute to the team in a broader cross-functional capacity.   In this position, you will be engaging with M&C teams that are driving both acquisition and member retention.  You will support the internal client facing teams offering technical and data insights to influence bot ... More
  • Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #462
    Tuesday, February 11, 2020
    Full-time, Non-ExemptThis role will be responsible for ensuring great member and provider experience by accurately and efficiently processing claims adjustments, while concentrating on putting our customers at the center of how Operations operates. Ensures accurate and timely processing of claim adjustments/service forms and ad-hoc projects/retro database items in accordance with medical and ancillary guidelines and benefits. Acts as a liaison with other department and outside vendors to resolve ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #283
    Monday, February 3, 2020
    Status: Non-exempt / Part timeSchedule:  Daily, Mid-day hours, 4 hours/day JOB SUMMARY:Under the direction of the Executive Assistant, IT&TS / CIO:Performs administrative duties for IT leadership team as well as provides general administrative support to the entire IT&TS department across three offices (onsite support of Rochester staff, remote support of Schenectady and Tarrytown staff as needed).  Schedule management for department leaders, scheduling and coordination of onsite and offsite mee ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #444
    Wednesday, January 22, 2020
    Full-time, Non-Exempt   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 various source ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #434
    Monday, January 6, 2020
    Full-time, Non-ExemptProvides customer service on a wide range of technical issues to internal MVP employees and external constituents in busy call center environment. Works scheduled phone support shifts comprising a significant portion of the workweek. Resets passwords and troubleshoots basic desktop PC issues. Process, routes and tracks incoming service requests. Performs basic desktop PC support mainly via telephone. Logs calls in trouble ticketing system. Provides follow-up phone calls and/ ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #329
    Tuesday, December 31, 2019
    Professional, Case Manager    Status: Full-time, Exempt: Yes        Summary: This position will utilize the essentials of an integrated case management model that includes assessment, planning, implementation, care coordination, monitoring and advocacy to meet the member’s overall comprehensive health needs. Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of designated members, act as a proactive partner, and provide appropriate education, r ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA; Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA
    Req #419
    Thursday, December 12, 2019
    Full-Time, Non-ExemptTo act as the Subject Matter Expert of all participating Provider and Facility data entry in Cactus and Facets. Monitors and records the quality of work performed by PDM Service Form Associates within the Provider Data Management Department for accuracy of participating provider record set up in Cactus and/or Facets. Completes quality check on all delegated provider data and provides QC Stats. Identify trends of specific errors and error rates. Research and identify gaps in ... 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
  • 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
  • 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
    Req #271
    Thursday, August 29, 2019
    Status: Full-time, Exempt     This role works with the CRM staff, Marketing & Communications, Business Areas, and the IT Development team to develop the training program for specific CRM initiatives and applications. This position will design, write, and develop instructor-led and technology delivered courses using content developmental tools and will work with business experts to refine course content based on process and training needs, while meeting MVP brand and communication standards. The ... More
  • Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA
    Req #229
    Monday, August 5, 2019
    Status: Full-time, Exempt: Yes Status: Full-timePosition Summary Responsible for Provider Partner business development, strategic account management, negotiating VBP and alternate payment model contracts in the region and implementing strategic account plans for key provider relationships representing a significant proportion of MVP’s membership and clinical expenditures.  Works with Network leadership, team members, key leaders/contributors across the organization, as well as key leaders/cont ... More
  • Tarrytown Office, 303 South Broadway, Tarrytown, NY, USA
    Req #152
    Monday, July 8, 2019
    The Professional, Special Services Liaison will be the liaison with external agencies to ensure coordination with the services they are providing to MVP Medicaid members. As liaison to county Foster Care Coordinators or Voluntary Foster Care Agencies, this role will act as primarycontact person to assist with enrollment, disenrollment, and access to care for the foster care children.This professional will work with MVP Care Managers, Foster Care Coordinator, hospitals, and/or Health Home Care Ma ... 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 #151
    Monday, July 1, 2019
        Status: Full-time, Exempt   Summary: Leads MVP’s efforts to enhance business discipline of and collaboration between Utilization Management, Case Management, Appeals and other divisions of the Health Management Department to improve clinical outcomes across all business lines.Co-leads Medical Operations’ efforts to vision, implement and execute on an Integrated Health strategy.Leads Medical Operations efforts to implement and execute Quality initiatives in a highly matrixed environmen ... More
  • 625 State St, Schenectady, NY 12305, USA
    Req #114
    Monday, June 17, 2019
    Status: Full-time, Exempt           Summary: The role will be responsible for driving the successful activation and adoption of Dynamics365 CRM throughout the enterprise – this will be achieved by acting as the hero/ambassador/champion/coach for MVP departments and stakeholders; executing on-point and pertinent training, coaching and advocacy by ultimately immersing yourself into the end-user’s world.  With a direct focus on usage, adoption and evolvi ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #102
    Thursday, June 13, 2019
    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 various sources (hospitals ... More
  • 5455, 303 S Broadway # 321, Tarrytown, NY 10591, USA
    Req #94
    Wednesday, June 12, 2019
    Associate, Outreach Representative      Status: Full-time, Exempt: No Referral Bonus: Standard Talent Acquisition Representative: Rosemary Troncoso, rtroncoso@mvphealthcare.com Location: Tarrytown   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 ... More