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  • Virtual
    Req #745
    Monday, March 1, 2021
    Support MVP’s Commercial Health Promotion Team evolve and develop Mental Health Resources to serve our MVP Customer’s. Work with MVP’s vendor partners to bring resources to address Social Determinants of Health with MVPs Commercial Aged Population. Assist in the development and deployment of Virtual Well-Being Resources to MVP’s Commercial Aged Population and greater community members. Serve as a liaison and extension of MVP’s Well-Being Strategists to support Strategic Customer Engagement.  T ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #743
    Friday, February 26, 2021
    Status: Full-time, Exempt Summary:Provide technical and administrative oversight to a team of Medicaid, Essential Benefits, Child Health Plus and cross-functional Integrated Health Claim Examiners for adjudication of claims. Responsibilities will include ensuring that all activity is consistent with company policies and procedures. The role will also provide oversight and direction in the duties of monitoring attendance, personnel issues, and performance evaluations, interviewing and completing ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA ● Virtual
    Req #729
    Thursday, February 25, 2021
    Status: Full-time, Exempt  Provides clinical expertise and timely first and second level clinical determinations based on MVP’s policies/procedures, state and federal guidelines, national accreditation standards, benefits interpretations, and other medical necessity criteria as necessary. Supports 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 clinic ... 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 ● Virtual
    Req #739
    Thursday, February 25, 2021
    Status: Full-time, Exempt  Provides clinical expertise and timely first and second level clinical determinations based on MVP’s policies/procedures, state and federal guidelines, national accreditation standards, benefits interpretations, and other medical necessity criteria as necessary. May conduct pediatric reviews. Lead’s MVP’s efforts to collaborate in person and virtually with behavioral health network providers and facilities around clinical determinations, policy interpretatio ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #744
    Wednesday, February 24, 2021
    Status: Full-time, Exempt: YesSUMMARY The Underwriter will analyze large accounts for group quote determination in accordance with MVP’s filed rates and methodologies as well as manage the experience rated block of business to produce desired MLR and profit targets. In addition, the underwriter provides support for the sales and account management teams regarding group renewals and prospects, including strategy, product offerings, data review, and managing quote turn-around times.  The und ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #741
    Tuesday, February 23, 2021
    Summary This role is responsible for monthly investment processing, general ledger recording and reconciliation of assigned   companies. Prepare  investment schedules for NAIC quarterly and annual filings of assigned companies. Assist in preparation of monthly investment reports for the Finance Committee.  Process  electronic funds transfers and prepare daily cash  position reports, including cash  forecasts as needed. Prepare  monthly reconciliations ... More
  • Rochester Office, 220 Alexander Street, Rochester, NY, USA
    Req #742
    Monday, February 22, 2021
    JOB TITLE:                                          Associate, Medicare Appeals Coordinator STATUS:                                              Associate II, Full-time, Non-Exempt HOURS:                                               Monday – Friday, 8:30 am - 5:00 pm                                                             Alternate weekends and holidays JOB SUMMARY: Thoroughly investigates and resolves member appeals and CTM’s in a professional and timely manner follow ... 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 #737
    Friday, February 19, 2021
    This role will accomplish strategic objectives by leading multiple projects and initiatives. Responsibility for projects includes the direction, coordination, implementation, execution, controls and completion of project, while remaining aligned with strategy, commitments and goals of the organization. Responsible for the gathering and articulation of business requirements. Evaluates all business processes and assists in developing and implementing process improvements to increase efficiency. 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 #740
    Friday, February 19, 2021
    The Data Scientist will design and develop reports and analyze data to measure clinical and financial outcomes.This role will investigate key business problems through quantitative analyses of clinical data, risk, utilization, and health care costs.Specifically, the Data Scientist will work closely with clinical and business leaders to drive trending and operational analytics for population identification, program need, and emerging risk.The successful candidate will employ subject matter expert ... 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 #681
    Friday, February 19, 2021
    We have two opportunities to join our Legal team! JOB SUMMARY: Under the direction of the Managing Counsel, provides legal advice and business counsel to the Company’s operational units in a variety of subject areas, as assigned; applies sophisticated legal concepts and business principles in accordance with company and departmental objectives to solve challenging issues in practical ways; balances and prioritizes multiple projects for timely completion; possesses high aptitude for legal ... 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 #738
    Wednesday, February 17, 2021
    Job Summary: • Manage and monitor real-time call and contact volume, forecasting, and resource capacity of a high-volume contact center spread across three locations to ensure efficient staff scheduling to meet service level targets and achieve key performance indicators.   • Support Customer Care Center leaders in effective scheduling of staff and real-time performance monitoring to meet performance goals. • Interpret, analyze, and make recommendations to improve workforce efficiency i ... 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 #736
    Tuesday, February 16, 2021
    Summary Facilitates Customer Care Center call quality review program. Oversight of call monitoring and call coach development, standards implementation and review, quality training and feedback, performance tracking, and communication geared towards overall employee development. Performs statistical analysis to review opportunities for process and workflow improvement and implements improvements. Coordinates training. Oversees MVP HIPAA standards including employee training and development ... More
  • Virtual
    Req #735
    Tuesday, February 16, 2021
    This position works as part of an integrated team designed to provide cross-functional communication and marketing expertise to the business with a focus on Internal and Corporate communications.  The team is comprised of creative content strategists who develop content with passion and enthusiasm on a variety of topics to inform and engage MVP Health Care colleagues.   Individual job responsibilities include developing marketing and communication strategies; implementing communication ta ... 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 #734
    Tuesday, February 16, 2021
    Provider Services, Associate, Care CenterStatus: Full-time or Part-time opportunities, 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 via telephone with combination of in office and/or virtually and written correspondence/ e-mail with our customers as needed. Representatives ma ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #733
    Monday, February 15, 2021
    In this capacity, incumbent will lead strategic initiatives as defined by executive leadership within the organization, serving as an initiative implementor, manager and resource to the leadership team, under the direction and support of the Senior Leader, Enterprise Risk & Administration. The incumbent will drive the success of strategic initiatives by creating tactical implementation plans & strategy, presenting the plans & strategies to stakeholders, and communicating, collaborating, and supp ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 220 Alexander Street, Rochester, NY, USA ● Virtual
    Req #731
    Friday, February 12, 2021
    Status: Full-time, ExemptBe a part of the transformation at MVP Health Care. We are continually evolving the way MVP uses technology to grow our business, transforming the organization through Cloud Computing, Agile Delivery, and DevOps. The Software Engineering Leader is a critical part of this transformation. The Software Engineering Leader has primary responsibility for managing a team of highly skilled engineers & developers that plan, design, and developing applications for MVP. The Softwar ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 220 Alexander Street, Rochester, NY, USA ● Virtual
    Req #728
    Thursday, February 11, 2021
    Status: Full-time, Exempt Summary: The Technical Product Owner is a critical part of this transformation. MVP is looking for an experienced product owner, who is self-motivated, technically savvy, and can develop and maintain strong business development relationships with their internal customers. The individual will be able to carry technical knowledge into strategic conversations and assist in bridging their customer needs with technology capabilities. Work with Business Relationship Managers ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA ● Virtual
    Req #730
    Thursday, February 11, 2021
    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
    Req #725
    Friday, February 5, 2021
    Full-Time, Exempt This role will accomplish strategic objectives by leading multiple projects and initiatives and well as leading a team of project managers. Responsibility for projects includes the direction, coordination, implementation, execution, controls, and completion of project, while remaining aligned with strategy, commitments, and goals of the organization. The role has oversight of the purpose and status of the projects across Operations at MVP and can use this oversight to support p ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA
    Req #723
    Friday, February 5, 2021
    Full-Time, Non-exempt Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess Systems. Reviews and ensures the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible. Reviews and ensures the accuracy of all changes to claim line information based on information received from other departments and in accord with available benefit information. Is responsible for the timely and accurate adjudication ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA ● Virtual
    Req #700
    Friday, February 5, 2021
    Status: Full-time, Exempt: Yes A Security Engineer works to ensure MVP’s systems and business critical functions are secure and available. In this position the individual will design, build, test, and implement security systems within MVP’s business and IT environment. The Security Engineer must have a good understanding of MVP's IT systems to anticipate possible security risks, identify areas of weakness, and respond effectively to possible security incidents and breaches. Will be respo ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 220 Alexander Street, Rochester, NY, USA ● Virtual
    Req #721
    Friday, February 5, 2021
    Status: Full-time, Exempt  Provides professional oversight, leadership and guidance over the day-to-day operation of the Care Management Team. Ensures the development, implementation, coordination, and evaluation of the team's job responsibilities. Performs quality checks and supports the team in meeting their productivity measures.  Designs and maintains processes and workflows to support internal programs and coordination with other interfaces as relevant. Interviews, recommends for hire, ori ... 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 #722
    Thursday, February 4, 2021
    Status: Full-time, Non-Exempt Summary: Addresses phone calls regarding inquiries, questions, and concerns relating to member Flexible Spending Accounts and Health Reimbursement Accounts.  Has a goodunderstanding of Flexible Spending Accounts (FSA’s), Health ReimbursementArrangements (HRA’s) and governing IRS Guidelines. Setup and maintain clientand participant account information within the Alegeus claims paymentsystem.  Supports processing of claims  disbursements, andweekly/monthly reporting.  ... 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 #719
    Wednesday, February 3, 2021
    The Informatics Analyst will work on standard and adhoc analysis in support of key corporate initiatives for MVP’s Quality Improvement team, with the goal of providing tools for strategic decisions and recommendations for change. Activities will include performing analyses on cost, utilization, quality and population health metrics; consulting with internal stakeholders on business needs; acquiring and assembling new data; developing new metrics and measures, and conducting research on methodolo ... More
  • Headquarters Office, 625 State Street, Schenectady, NY, USA ● Rochester Office, 220 Alexander Street, Rochester, NY, USA ● Virtual
    Req #718
    Tuesday, February 2, 2021
    Full-Time, Exempt This role is for someone who has a complete and extensive understanding of the Dynamics 365 platform. The role will leverage this knowledge when solving business process issues and implementing new business areas to the platform. This role will work closely with all departments implementing and ensuring the CRM tool-set works effectively across teams while maximizing efficiency and capitalizing on the full features and benefits of the Dynamics platform. Participate in planning ... More