MVP Health Care jobs in Schenectady, NY - 6490 jobs
Leader, Quality Analytics Operations
MVP Health Care 4.5
MVP Health Care job in Schenectady, NY
**Join Us in Shaping the Future of Health Care** At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team.
**What's in it for you:**
+ Growth opportunities to uplevel your career
+ A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team
+ Competitive compensation and comprehensive benefits focused on well-being
+ An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work For in the NY Capital District** , one of **the Best Companies to Work For in New York** , and an **Inclusive Workplace** .
You'll contribute to our humble pursuit of excellence by bringing curiosity to spark innovation, humility to collaborate as a team, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more vibrant communities.
**Qualifications you'll bring:**
+ Bachelor's Degree preferred; will consider equivalent experience.
+ Three years' experience with data analysis and/or health care quality operations.
+ Possess strong personnel management skills.
+ Experience with HEDIS, Medicare Stars, and NYSDOH QARR reporting requirements.
+ Possess strong analytical skills with detailed knowledge of healthcare operations and datasets.
+ Possess strong problem-solving skills with a keen attention to detail.
+ Proven ability to work under pressure and manage multiple priorities effectively.
+ Self-motivated, proactive, and capable of driving initiatives independently.
+ Excellent communication and collaboration skills across cross-functional teams.
+ Microsoft SQL.
+ Interpersonal skills (e.g., partnering, conflict management, mentoring), with strong verbal and written communication skills, and the ability to interact with most levels of business, technical and end users.
+ Strategic Thinking: Aligns analytics operations with organizational priorities and anticipates future needs.
+ Influence & Collaboration: Builds strong relationships and fosters cooperation across teams and departments.
+ Decision-Making: Demonstrates sound judgment and data-driven decision-making under pressure.
+ Change Leadership: Champions innovation and process improvements, including automation initiatives.
+ Talent Development: Mentors and develops team members to achieve peak performance.
+ Accountability: Holds self and team responsible for delivering high-quality, timely results.
+ Curiosity to foster innovation and pave the way for growth.
+ Humility to play as a team.
+ Commitment to being the difference for our customers in every interaction.
**Your key responsibilities:**
+ Lead and execute quality analytics to support organizational excellence.
+ Manage annual HEDIS data submissions, including completion of the HEDIS Roadmap, audit coordination, and support for the medical record review project.
+ Oversee data processes and deliverables for regulatory and performance programs.
+ Collaborate with business, technical, and Data Governance teams to ensure data integrity and availability.
+ Monitor and enhance data accuracy, reliability, and compliance standards.
+ Identify and implement process improvements and automation to increase efficiency and reduce technical debt.
+ Acquire and integrate data as needed to support quality improvement initiatives.
+ Foster collaboration by encouraging cross-functional teamwork and promoting cooperation across organizational boundaries.
+ Serve as a trusted partner to internal and external stakeholders, ensuring expectations and requirements are met.
+ Other duties as assigned by leadership **.**
+ Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.
**Where you'll be:**
Hybrid in Fishkill, Rochester, Schenectady or Tarrytown, NY
**Pay Transparency**
MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.
We do not request current or historical salary information from candidates.
$121,767.00-$161,949.75
**MVP's Inclusion Statement**
At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.
MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.
To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at ******************** .
$121.8k-161.9k yearly 20d ago
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Broker Engagement Leader
MVP Health Care 4.5
MVP Health Care job in Schenectady, NY
**Join Us in Shaping the Future of Health Care** At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team.
**What's in it for you:**
+ Growth opportunities to uplevel your career
+ A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team
+ Competitive compensation and comprehensive benefits focused on well-being
+ An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work For in the NY Capital District** , one of **the Best Companies to Work For in New York** , and an **Inclusive Workplace** .
You'll contribute to our humble pursuit of excellence by bringing curiosity to spark innovation, humility to collaborate as a team, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more vibrant communities.
**About the Opportunity**
As a Broker Engagement Leader you will be responsible for assisting your team build and maintain strong relationships with brokers for all lines of business.
**What You'll Do**
+ Assist in managing and maintaining relationships with brokers, ensuring effective communication and timely resolution of any issues.
+ Support your team with the onboarding process for new brokers, including gathering necessary documentation and coordinating with internal stakeholders.
+ Collaborate with cross-functional teams to ensure seamless integration of broker administration processes with other business functions.
+ Stay updated on industry trends and best practices related to broker engagement and share knowledge with the team.
+ Identify possible new business solutions
+ Work with your team to provide brokers with product knowledge (when necessary), updates on company policy, and training on best practices to optimize MVP Client Servicing.
+ Management & cultivate relationships with our brokers through regular communication and strategic communication.
+ Other duties as assigned by leadership.
**Skills and Experience**
+ **Education, Licensures, & Certifications**
+ Bachelor's degree in business administration, finance, or a related field.
+ **Years of Experience (Required & Preferred)**
+ Proven experience in broker administration or a similar role.
+ **Required Job Skills**
+ Strong analytical skills with the ability to interpret data and provide actionable insights.
+ Excellent communication and interpersonal skills to effectively collaborate with brokers and internal stakeholders.
+ Detail-oriented with strong organizational skills to manage multiple tasks and prioritize effectively.
+ Proficient in using Microsoft Office Suite, particularly Excel, for data analysis and reporting.
+ **Preferred Job Skills**
+ Knowledge of the insurance industry and broker management systems is a plus.
**Worksite Designation**
+ Hybrid in Rochester or Schenectady, NY
**Pay Transparency**
MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.
We do not request current or historical salary information from candidates.
$69,383.00-$92,279.00
**MVP's Inclusion Statement**
At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.
MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.
To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at ******************** .
Award winning personal injury law firm located in Dallas, Texas is seeking a highly motivated Personal Injury Attorney. The ideal candidate will have a minimum of five years of plaintiff-side personal injury experience, trial experience, excellent writing skills, and experience drafting motions for summary judgment, motion to compel, pleadings, and answer discovery. The candidate should also have trial experience and great client communication.
Responsibilities:
* Manage a litigation case load of up to 40 - 50 cases at a time.
Requirements:
Minimum of five years of Plaintiff-side personal injury experience.
* Ability to draft pleadings, motions, and discovery responses.
* Trial experience
* Great client communication skills.
* Strong investigative skills.
* Full time in office
Yearly salary plus a guaranteed bonus structure.
If you meet the requirements and are interested in joining our team, please submit your resume and cover letter for consideration.
Job Type: Full-time
Pay: $80,000.00 - $125,000.00 per year
Benefits:
* 401(k)
* 401(k) matching
* Health insurance
* Paid time off
* Retirement plan
* Vision insurance
Experience:
* Plaintiff Litigation Personal Injury : 5 years (Required)
Work Location: In person
$80k-125k yearly 23m ago
Office Manager and Executive Assistant to Managing Partner
U.S. Realty Advisors, LLC 4.5
New York, NY job
Executive Assistant to Managing Partner
U.S. Realty Advisors is seeking a polished, proactive, and highly personable Executive Assistant & Office Manager to support our Managing Partner and keep our NYC office running seamlessly. This role is perfect for someone who thrives in a fast‑paced, high‑standards environment and enjoys being the go‑to person who makes the whole operation work.
What you'll do
Serve as a trusted extension of the Managing Partner-calendar management, travel coordination, expenses, and confidential support
Manage day‑to‑day office operations: payables, vendors, supplies, building coordination
Organize team events, assist with onboarding, and help cultivate a warm, professional office atmosphere
Ensure the office remains polished, efficient, and welcoming
Who you are
5+ years supporting senior executives (finance/real estate a plus)
Exceptionally strong interpersonal skills with a polished, confident demeanor
A “no job is too small” mindset paired with strong organizational instincts
Positive attitude-genuinely enjoys being part of a collaborative, high‑performing team
Discreet, proactive, detail‑obsessed, and calm under pressure
Bachelors degree
Why U.S. Realty Advisors
Join a high‑performing team where professionalism, trust, and collaboration drive results. You'll directly support firm leadership and play a central role in the culture and daily operations of our NYC office.
$47k-72k yearly est. 5d ago
Technical QA Analyst II
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Location: Remote (For Non-Local) or Hybrid (Local to NYC area)
Position Summary:
The Technical QA Analyst II is a critical contributor to delivering high-quality products within the Capital Rx JUDI platform, aligning with business goals and exceeding user expectations. Working closely with Product Managers, engineers, and stakeholders, this role ensures the seamless execution of the product roadmap by proactively identifying and resolving technical issues, validating functionality, and enhancing user experiences. This role combines a detail-oriented approach to quality assurance with a collaborative mindset to drive operational efficiency, support clinical programs, and deliver innovative solutions that benefit all Capital Rx members and clients. A strong technical aptitude and ability to deeply analyze system behavior are essential
Position Responsibilities:
Technical Issue Identification & Root Cause Analysis: Identify, investigate, and triage technical issues within the JUDI tech stack (specifically focusing on [Specify Key Technologies - e.g., Python/Django, PostgreSQL, AWS services]). Conduct thorough root cause analysis, utilizing logs, database queries, and system monitoring data to pinpoint the source of problems.
Log Analysis & Monitoring: Monitor and analyze system logs (e.g., using CloudWatch, Datadog, or New Relic) to validate application functionality, identify performance bottlenecks, and proactively detect anomalies. Develop and maintain dashboards to visualize key system metrics.
Database Querying & Analysis: Utilize SQL to query and analyze data within the JUDI database (PostgreSQL preferred). Develop and execute complex queries to investigate data discrepancies, identify trends, and support troubleshooting efforts. Familiarity with SQLAlchemy is a plus.
AWS Service Support: Collaborate with the engineering team on the support and monitoring of AWS services utilized within the JUDI platform (e.g., EC2, S3, Lambda, RDS). Assist with troubleshooting issues related to these services.
Collaboration & Requirements Translation: Collaborate with Product Managers and engineers to understand business requirements and translate them into actionable test requirements and test plans. Participate in sprint planning and daily stand-ups.
QA Execution: Conduct thorough QA tasks, including ticket review, refinement, testing (manual and potentially exploratory), and bug identification.
Scrum Team Support: Partner with the scrum team to manage backlogs, refine tickets, and support roadmap development.
UAT Support: Assist with UAT testing, stakeholder communication, and documentation to align team efforts with business goals.
Compliance & Reporting: Ensure adherence to company policies, including timely reporting of noncompliance.
Code of Conduct: Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
Minimum Qualifications:
Bachelor's degree strongly preferred in Computer Science, Information Technology, or a related field.
3+ years of experience in a QA Analyst, Software Engineer, Business Analyst, or related role.
Proficiency in Python
Strong SQL experience; familiarity with SQLAlchemy is preferred.
Experience with logging and monitoring tools such as CloudWatch, Datadog, or New Relic.
Familiarity with Agile methodologies and workflows.
Experience with GitHub or similar source control repositories.
Excellent communication and collaboration skills, with the ability to translate between technical and non-technical audiences both verbally and in writing.
Strong analytical and problem-solving skills with attention to detail and QA principles
Preferred Qualifications:
Experience with Infrastructure as Code (IaC) tools like Terraform or CloudFormation.
Knowledge of API testing methodologies.
Experience with CI/CD pipelines.
Understanding of data warehousing concepts.
Experience in the PBM space.
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Salary Range$85,000-$100,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$85k-100k yearly 6d ago
Contract Manager
Island 4.4
Dallas, TX job
What if the enterprise had complete control over the browser? What would it mean for security, for productivity, for work itself?
Introducing Island, the Enterprise Browser - the ideal enterprise workplace, where work flows freely while remaining fundamentally secure. With the core needs of the enterprise naturally embedded in the browser itself, Island gives organizations complete control, visibility, and governance over the last mile, while delivering the same smooth Chromium-based browser experience users expect. Led by experienced leaders in enterprise security and browser technology and backed by leading venture funds -- Insight Partners, Sequoia Capital, Cyberstarts and Stripes Capital -- Island is redefining the future of work for some of the largest, most respected enterprises in the world.
The Contracts Manager works with the Island legal team in supporting Island in its sales and procurement processes. The responsibilities include primary management and oversight of the Contract Lifecycle Management (CLM) and interfacing with CRM systems, and working with Island's sales and procurement teams through the contracting process.
You will also:
implement best practices for contract intake, triage, approvals and signature workflows;
maintain accurate records in the CLM and CRM systems; and
produce metrics on cycle times and negotiation trends. This role will work closely with Island's internal team of attorneys , as well as business stakeholders at all levels of the company.
Note: This position is 100% in-office at our Coppell, TX headquarters near Dallas (Monday through Friday). We believe collaboration and culture thrive face-to-face, and we can't wait to welcome you to the team.
About you:
Excellent written, oral and presentation skills and an ability to synthesize information and make clear, concise recommendations on course of action.
Strong interpersonal skills with the ability to effectively work with all levels of company management and stakeholders, external customers, and outside counsel.
Problem solving, decision-making, analytical and critical thinking skills.
Demonstrated initiative and ability to work independently and as part of a team.
Strong work ethic and organizational skills.
Must be proficient in Microsoft Word and Google Docs.
Proficiency in CLM and CRM systems, G Suite, IronClad, and DocuSign is a plus.
Ability to handle multiple tasks while maintaining attention to detail
Requirements you should have:
Bachelor's degree. Experience in a related position of increased responsibility will be considered in lieu of degree.
4+ years' experience in managing the life cycle of commercial contracts including drafting, negotiation, approval, and execution.
Experience in technology startups or Software-as-a Service is a plus.
Areas you will be impacting:
Generate, review, analyze, interpret, modify, and negotiate commercial contracts, with a focus on customer facing agreements and procurement agreements, including non-disclosure agreements (NDAs), SaaS, software license agreements, data privacy agreements (DPAs), partner and reseller agreements, etc.
Drive deals from intake through execution, streamline templates and playbooks, and strengthen our contracting infrastructure, including our CLM and related processes.
Ensure the contract is reviewed, approved, and signed in accordance with the Island's contract management procedures.
Maintain internal documentation of contract processes.
Drive automation and efficiency for the contract lifecycle.
Assist Island's attorneys to manage, update and maintain Island's contract templates.
Perform other related duties, as assigned.
$69k-106k yearly est. 4d ago
Clinical Account Consultant, PBA
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Position Summary:
Capital Rx is seeking a strategic, client-focused Clinical Account Consultant to support all aspects of clinical functions to service client clinical needs. In this role, you'll ensure client satisfaction, retention, and trend management, while providing clinical support to clients across all lines of business. You'll collaborate directly with clients to develop and implement formulary and clinical strategies, support contract renewals, and contribute to clinical process improvements. If you're passionate about delivering exceptional service with a focus on clinical excellence and driving healthcare innovation, we'd love to hear from you!
Position Responsibilities:
Support clinical aspects of implementation for new clients, plans, plan changes, and other clinical plan set-up requirements. This may include gathering client clinical intent and plan requirements, building/coding plans and formularies, conducting peer-review quality control, and reviewing testing and claims output.
Actively address all clients' clinical needs including the management and implementation of custom formularies, clinical criteria, and clinical strategies.
Comprehend and effectively explain formulary, benefit, and clinical programs to clients, including intervention components, member and plan experience, book of business experience, and regulatory requirements as it directly pertains to clinical functions.
Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations with supportive rationale for formulary, clinical and plan management strategies.
Analyze and interpret pharmacy claims data to identify clinical and plan trends and to offer insights for individual clients and across multiple clients.
Communicate drug information to clients and respond to plan-specific clinical inquiries; support resolution of member-specific inquiries.
Collaborate with cross-functional teams to support sales initiatives, requests for information (RFI), requests for proposal (RFP), and prospect presentations.
Actively attend and contribute to sales meetings and client presentations with a focus on clinical operations and clinical account management.
Lead key internal clinical operations initiatives and general business needs/operations, as required.
Identify and contribute to clinical process improvement efforts.
Certain times of year may require meeting participation, testing, claims review, or other requirements outside of standard business hours, including weekends.
Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
Required Qualifications:
Doctor of Pharmacy (PharmD) degree from an accredited institution
Current, unrestricted registered pharmacist license(s)
Relevant experience of 3-5 years in a health plan or pharmacy benefits management (PBM)
Direct account management experience supporting clients across multiple lines of business
Proficient in Microsoft Office Suite with emphasis on Microsoft Excel
Experience working with large datasets and analyzing raw data in Excel
Ability to balance multiple complex projects simultaneously
Exceptional written and verbal communication skills
Flexible, highly organized, and able to shift priorities easily
Attention to detail & commitment to delivering high quality work product
Ability to travel and present to small and large groups
Preferred Qualifications:
Completion of managed care residency, preferred
Prior account management experience of at least three (3) years, preferred
Prior experience with Medicare line of business, preferred
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Salary Range$145,000-$165,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$145k-165k yearly 6d ago
IT Help Desk Asset Technician
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Location: NYC Office (4 days/week required)
Position Summary:
The IT Help Desk Asset Technicianassistsin managing our ticketing system, MDM software, and all IT equipment tracking/deployment.
Position Responsibilities:
Manage all IT Asset inventory, tracking all in office/deployed equipment using IT Asset management programs
Maintain all IT assets through device life cycle, processing replacements/returns of all broken/outdated hardware across the company
Collaborate with HR team to retrieve equipment from
Collaboratewith internal partner teams toidentifycompliance, best practice, or other IT related policy needs within the cross functional existing processes and workflows;identifyand present enhancements and deploy solutions to the business.
Responsible for all onboarding and offboarding related IT activities, including system-wide access,purchasingandretrieving ofequipment,upgrades,asset tagging,etc.
Promptly respond to user requests via ticketing system/phone calls/IM
Assistusers with access/system issues
Write and update documentation for user reference
Help build andestablishprocedures for newly established team
Participate in a Help Desk OnCall schedule (tentatively will be 1 week/month, with potential higher volume at onset as the team grows).
Required Qualifications:
2+Yearsexperiencein a Help Desk role (preferably in a medium or larger company)
Acustomer-orientedapproach to problem resolution
Experience maintaining IT Assets within asset management software
Process, intake, and manage hardware repairs
Ability to lift 30 lbs. regularly and up to 50 lbs. occasionally (for NYT "future onsite" roles only)
Salary Range$24-$28 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$24-28 hourly 2d ago
Data Quality Engineer
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Location: Remote (For Non-Local) or Hybrid (Local to NYC area)
Position Summary:
We are seeking a highly motivated and detail-oriented Data Quality Engineer to join our team. In this critical role, you will be the guardian of our data's integrity, ensuring the accuracy, reliability, and robustness of the systems that power our operations and analytics. You will be instrumental in building trust in our data and empowering the organization to make confident, data-driven decisions that drive positive healthcare outcomes.
Position Responsibilities:
Technical Issue Identification & Root Cause Analysis: Identify, investigate, and triage technical issues within the data engineering tech stack (specifically focusing on [Specify Key Technologies - e.g., Python, SQL, Airflow, dbt]). Conduct thorough root cause analysis, utilizing logs, database queries, and system monitoring data to pinpoint the source of problems.
Log Analysis & Monitoring: Monitor and analyze system logs (e.g., using CloudWatch to validate application functionality, identify performance bottlenecks, and proactively detect anomalies. Develop and maintain dashboards to visualize key system metrics.
Database Querying & Analysis: Utilize SQL to query and analyze data within the Snowflake data warehouse. Develop and execute complex queries to investigate data discrepancies, identify trends, and support troubleshooting efforts. Familiarity with SQLAlchemy is a plus.
AWS Service Support: Collaborate with the engineering team on the support and monitoring of AWS services utilized within data engineering (g., EC2, S3). Assist with troubleshooting issues related to these services.
Collaboration & Requirements Translation: Collaborate with Product Managers and engineers to understand business requirements and translate them into actionable test requirements and test plans. Participate in sprint planning and daily stand-ups.
QA Execution: Conduct thorough QA tasks, including ticket review, refinement, testing (manual and potentially exploratory), and bug identification.
Scrum Team Support: Partner with the scrum team to manage backlogs, refine tickets, and support roadmap development.
UAT Support: Assist with UAT testing, stakeholder communication, and documentation to align team efforts with business goals.
Compliance & Reporting: Ensure adherence to company policies, including timely reporting of noncompliance.
Code of Conduct: Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
Minimum Qualifications:
Bachelor's degree strongly preferred in Computer Science, Information Technology, or a related field.
3+ years of experience in a QA Analyst, Data Engineer, Business Analyst, or related role.
Proficiency in Python
Strong SQL experience; familiarity with Snowflake preferred.
Familiarity with Agile methodologies and workflows.
Experience with GitHub or similar source control repositories.
Excellent communication and collaboration skills, with the ability to translate between technical and non-technical audiences both verbally and in writing.
Strong analytical and problem-solving skills with attention to detail and QA principles
A meticulous, detail-oriented mindset with a passion for ensuring data accuracy.
Preferred Qualifications:
Experience in the healthcare or PBM sector.
Hands-on experience with modern data stack tools like Airflow, dbt, and Snowflake.
Experience with CI/CD pipelines.
Understanding of data warehousing concepts.
Familiarity with automated testing frameworks and data validation tools.
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Salary Range$85,000-$100,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$85k-100k yearly 6d ago
Quality Assurance (QA) Pharmacist
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Position Summary:
The QA Pharmacist will use their state regulatory knowledge to perform routine auditing and monitoring processes to ensure quality, accuracy, and regulatory compliance of coverage requests and appeals. The QA Pharmacist will utilize a strong comprehension of regulatory requirements to ensure success in annual reporting, program audits, and ad hoc audits.
Position Responsibilities:
Complete monthly utilization management and appeals performance and process audits in alignment with applicable regulations, accreditation standards, and best practices.
Create and maintain progress reports and audit results in accordance with regulatory/accreditation requirements and internal processes.
Present audit results to leadership in a timely manner to address issues and ensure adherence to departmental procedures and regulatory/accreditation requirements (CMS, URAC, NCQA).
Continuously review and remain informed of all regulatory/accreditation requirements and updates impacting the coverage request and appeals processes.
Respond to inquiries from internal and external stakeholders regarding quality assurance processes, audit results, and compliance policies and procedures.
Work independently and with team members as warranted by audit assignment.
Assist in designing and implementing audit tools and programs, creating QA scorecards and guides in collaboration with all department stakeholders.
Provide ongoing performance feedback, to team leads to ensure consistent performance.
Assist management in identifying, evaluating, and mitigating operational, and compliance risks.
Work in collaboration with operational leaders to identify training opportunities and recommend improvements to Work Instructions, Job Aids, and Policy and Procedures to improve performance.
Minimum Qualifications:
Active, unrestricted, pharmacist license required
2+ years of state regulatory and audit utilization management experience at a PBM or health plan required
Extensive knowledge of how to operationalize regulatory requirements
Strong oral and written communication skills required
Intermediate to advanced Microsoft Excel skills required
Possess strong analytical skills, attention to detail, quantitative, and problem-solving abilities
Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven work environment
Ability to multi-task and collaborate in a team with shifting priorities
Preferred Qualifications:
Familiarity/experience with URAC and NCQA accreditation requirements
Utilization management and/or appeals audit experience
3+ years of compliance or regulatory experience at a PBM or health plan
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
#LI-BC1
Salary Range$135,000-$145,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$135k-145k yearly 6d ago
Account Executive, PBA Services
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Position Overview:
The Account Executive/Strategic Account Executive - PBA Services is responsible for managing the planning, execution, growth & retention and client satisfaction of assigned clients in the Pharmacy Benefit Administration (PBA) market segment including Health Plans, Third Party Administrators (TPAs), and other Platform services. Additionally, this position will lead and collaborate through the broader Account Management team and with internal Capital Rx teams/departments as the client voice and advocate to ensure ongoing client satisfaction and to achieve client priorities and contractual obligations.
This position acts as the quarterback and leader of the broader Account Management team who are aligned in support of our clients. This position reports to the Senior Account Executive/Senior Director, PBA Client Services.
Position Responsibilities:
Work closely with some of our biggest Texas-based clients and manage the complexities of working within a highly-regulated market of the TDI (Texas Department of Insurance)
Provide oversight and direction to the broader Account Management team with a focus on member and client satisfaction, trend management, client growth & retention, and regulatory compliance to meet client specific objectives, client priorities and service model deliverables
Lead and develop the client relationship strategy and the strategic business planning process across the clients in your portfolio while incorporating other internal staff where and when needed to build and foster relationships with influencers and decision makers.
Maintain thorough knowledge and tracking of contractual obligations on assigned book of business, including financials, performance guarantees, terms, and reporting/compliance
Manage and facilitate the Account renewal and contracting process with a focus on client retention and the client financial/PNL management
Serve as the relationship lead on assigned book of business, incorporating other internal staff where and when needed to the relationship; build and foster relationships with influencers and decision makers at the client
Anticipates customer needs and proactively identifies new opportunities within assigned accounts.
Develop and maintain comprehensive knowledge of our business, including products and services to field questions from the client side and to answer timely & accurately
Collaborate with internal teams to customize offerings and solutions, aligning with Health Plan/TPA Account needs and market demands - assemble internal resources to overcomes challenges.
Analyze and interpret current pharmacy and healthcare trends, competitor activities, and industry regulations to inform strategic decisions, provide proactive recommendations for plan management and enhance the company's positioning within the PBA Services segment
Lead, coach and support the Account Team on the effective positioning of the Capital Rx value proposition, our suite of Capital Rx Products and Solutions and JUDI capabilities available to our PBA clients
Partner with our Business Development, Underwriting Teams & Senior Account Executives to support our PBA Account level growth and retention efforts by providing with Capital Rx sales support and market differentiator positioning, including RFP support, Broker/Consultant engagement and Best & Final support for prospective, existing and new and client business development needs
Provide ongoing direction, coordination and coaching to the broader Account Team to align the Account Team understanding of the assigned client(s) business lines, strategies, key stakeholders & decision makers and priorities
Serve as the content expert for Health Plan/TPA clients & opportunities
Identify and help contribute to process improvement efforts
Be accountable & own the client end-to end, inclusive of service model deliverables, contractual negotiations, client escalations and PNL management.
All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
Required Qualifications:
Bachelor's or advanced degree in health administration, business, or relevant professional experience. Bachelor of Pharmacy (B.S. Pharmacy) or Doctor of Pharmacy (PharmD) degree from an accredited institution is a plus
Relevant professional experience for at least five (5) years in pharmacy - working within a health plan, managed care, or pharmacy benefits management (PBM) focused on Health Plans and Payer Commercial (Insured, Self-Funded, Exchange) and Government Program (Medicare & Medicaid) business lines. Health plan industry experience highly preferred
Market and operational knowledge of Medicare Part D, Medicaid and Health Exchange pharmacy is required along with experience in supporting highly regulated business lines
Track record of building trust in internal and external relationships
Solution-focused problem solving and client positioning skills
Exceptional written and verbal communication skills
Ability to work with and influence peers in a team effort; leading cross-functional initiatives, meeting deadlines, and executing on deliverables while building strong internal relationships
A decisive individual with sound technical skills, analytical ability, good judgement, and strong operational focus and detail-oriented perspective
Flexible, highly organized, and able to shift priorities easily and work independently to meet deadlines
Ability to effectively work with peers in a team effort
Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and large data sets and other industry software programs
Ability to travel and present to small and large groups; travel is estimated to be up to 25% and be variable by season and business cycle
Preferred Qualifications:
Experience working with clients who are subject to TDI (Texas Department of Insurance) rules and regulations
#LI-BC1
Salary Range$120,000-$160,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$120k-160k yearly 6d ago
Billing Specialist
The Phoenix Group 4.8
New York, NY job
Join a dynamic financial operations team supporting legal professionals and their clients. This role centers on managing client financial interactions, with a focus on invoicing, digital billing platforms, and payment tracking.
Key Responsibilities
Prepare and submit client invoices, including digital formats, ensuring precision and timeliness
Oversee billing workflows, monitor deadlines, and provide status updates on outstanding accounts
Review and interpret custom billing agreements with a critical eye for detail
Serve as a point of contact for internal stakeholders, resolving process-related issues and supporting system enhancements
Collaborate directly with designated legal professionals to manage account lifecycles-from initial setup through payment coordination and account reconciliation
Candidate Profile
At least 2 years of experience in billing within a legal or consulting environment
Familiarity with enterprise financial platforms (e.g., Elite 3E, Aderant, eBillingHub)
Exposure to international billing practices and currency variations is advantageous
Strong analytical skills for interpreting financial data and billing trends
Exceptional accuracy and ability to follow complex instructions
Professional communication skills across all organizational levels
The Phoenix Group Advisors is an equal opportunity employer. We are committed to creating a diverse and inclusive workplace and prohibit discrimination and harassment of any kind based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. We strive to attract talented individuals from all backgrounds and provide equal employment opportunities to all employees and applicants for employment.
$41k-56k yearly est. 4d ago
2026 Summer Global Investments Intern- Investment Compliance
Aflac, Inc. 4.4
New York, NY job
Opportunity: Intern - Global Investments Salary Range: $18.75 -$30.00 per hour Company: Aflac Asset Mgt. LLC Division: Global Investment Recruiter: Alisha Hargrove Job Posting End Date: 2/9/2026 Worker Designation This role is hybrid. This means yo Investment, Compliance, Summer, Intern, Global, Management, Business Services
$18.8-30 hourly 2d ago
Proposal Development Manager
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Position Summary:
The Proposal Development Manager is an individual contributor responsible for leading the writing and project management of new-business medical RFPs and RFIs. In addition to directing all bid-development activities for Judi Health, the successful candidate will leverage industry expertise to help Judi Health identify and implement best practices for proposal response, establishing repeatable, efficient processes that scale with our growing pipeline.
The Proposal Development Manager will work closely with stakeholders across the organization to develop and deliver compelling, competitive value propositions that advance Judi Health's sales objectives and drive both client acquisition and retention. This new role offers the opportunity to shape and refine our proposal strategy from the ground up.
Position Responsibilities:
Lead RFP/RFI responses for Judi Health and Capital Rx prospects, covering medical and pharmacy components.
Develop and scale bid-management processes for medical administration/health benefits proposals.
Partner with enterprise content management and marketing teams to keep shared materials current, compelling, and competitive. This individual will assume ownership of the Judi Health and Judi Care sections of the content database.
Manage project plans, timelines, and resources to meet RFP requirements and ensure timely, complete submissions.
Customize proposal content based on regulatory guidelines, client demographics, utilization insights, and benefit design
Provide training and mentorship on proposal development best practices to subject matter experts and the proposal team, as it relates to the assigned market(s).
Streamline workflows through templates, automation, and tooling enhancements.
Uphold the Capital Rx/Judi Health Code of Conduct and report any noncompliance.
Required Qualifications:
Undergraduate bachelor's degree, with record of strong academic performance in English, Journalism, Marketing or Communications
5+ years of experience leading medical/health benefits administration proposal development.
Strategic writer the ability to think critically about client needs in order to derive rhetorically appropriate responses to non-standard questions.
High proficiency in Microsoft Word, Microsoft Excel, and Adobe products.
Attention to detail & commitment to delivering high quality work product.
Extremely flexible, highly organized, and able to shift priorities easily.
Ability to lead multiple complex projects simultaneously and balance a range of key internal and external stakeholders.
Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables.
Knowledge of healthcare industry trends and best practices.
Ability to write in plain language.
Exceptional verbal communication skills, with the ability to speak to executive leadership and find solutions.
Passion for learning, including intricacies of pharmacy benefits products and services.
Preferred Qualifications
Master's degree in English, Journalism, Marketing, Communications, or another related field.
Association of Proposal Management Professional and/or Project Management Professional certification.
Salary Range$115,000-$120,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$115k-120k yearly 2d ago
Clinical Investigator
MVP Health Care 4.5
MVP Health Care job in Schenectady, NY
**Join Us in Shaping the Future of Health Care** At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team.
**What's in it for you:**
+ Growth opportunities to uplevel your career
+ A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team
+ Competitive compensation and comprehensive benefits focused on well-being
+ An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work For in the NY Capital District** , one of **the Best Companies to Work For in New York** , and an **Inclusive Workplace** .
You'll contribute to our humble pursuit of excellence by bringing curiosity to spark innovation, humility to collaborate as a team, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more vibrant communities.
**Qualifications you'll bring:**
+ BA/BS degree in criminal justice or a related field, and minimum of five years ofinsurance claims investigation experience; or five years of professional investigation experience with law enforcement agencies, or seven years of professional investigation experience involving economic or insurance relatedmatters.
+ A clinical investigator must have in addition to the above requirements: A duly licensed or authorized medical professional, including but not limited to MD or RN.
+ New York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred.
+ Obtain CPC and/or COC credential.
+ Maintain nursing license and coding credentials through continuing education process as required.
+ Superior judgment skills, verbal and written communication, and presentation skills.
+ Extremely detail-oriented with excellent organizational and analytical skills.
+ Ability to utilize various data management tools to help identify potentially fraudulent activity.
+ Possess knowledge of CPT-4, ICD-9-CM, ICD-10-CM, HCPCS and CPT Assistant coding guidelines as they relate to claim data.
+ Working knowledge of MS Office (Word, Excel and Outlook)
+ Curiosity to foster innovation and pave the way for growth
+ Humility to play as a team
+ Commitment to being the difference for our customers in every interaction
**Preferred Job Skills:**
+ Working knowledge of Macess, Facets, CareRadius, Cognos, CMS web sites, and Encoder-Pro.
**Your key responsibilities:**
+ Conduct clinical reviews of various forms of medical documentation and records obtained from providers and facilities including but not limited to medical charts, patient account records, and member interviews.
+ Organize and conduct highly complex investigations. Document findings and recommendations throughout the investigative process in a timely and efficient manner according to corporate and departmental SIU policies and procedures.
+ Act as an SIU liaison and interact with and analyze data in cooperation with Pharmacy, Medical Affairs, Operations, Provider Relations, Credentialing, Customer Care Center, Legal and other corporate personnel.
+ Assist in investigations conducted by government agencies, law enforcement, and other insurance company SIU staff.
+ Make recommendations for and conduct clinical re-audits of providers and facilities previously audited by SIU.
+ Testify in criminal and civil legal case proceedings as necessary and assist outside legal counsel especially concerning issues needing clinical decision making.
+ Participate in annual Corporate FWA training and training of new SIU personnel.
+ Keep abreast of Federal and State Anti-Fraud investigation and reporting requirements including HIPAA, CMS, Medicare, Medicaid, and any corporate compliance initiatives or policies.
+ Minimal travel may be required pertaining to investigations and audits.
+ Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.
**Where you'll be:**
Virtual; Must reside within Eastern or Central Time Zone
**Pay Transparency**
MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.
We do not request current or historical salary information from candidates.
$69,383.00-$92,279.00
**MVP's Inclusion Statement**
At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.
MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.
To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at ******************** .
$69.4k-92.3k yearly 20d ago
Machine Learning Engineer
Trov 4.1
New York, NY job
At Pave, we're building the industry's leading compensation platform, combining the world's largest real-time compensation dataset with deep expertise in AI and machine learning. Our platform is perfecting the art and science of pay to give 8,500+ companies unparalleled confidence in every compensation decision.
Top tier companies like OpenAI, McDonald's, Instacart, Atlassian, Synopsys, Stripe, Databricks, and Waymo use Pave, transforming every pay decision into a competitive advantage. $190+ billion in total compensation spend is managed in our workflows, and 58% of Forbes AI 50 use Pave to benchmark compensation.
The future of pay is real-time & predictive, and we're making it happen right now. We've raised $160M in funding from leading investors like Andreessen Horowitz, Index Ventures, Y Combinator, Bessemer Venture Partners, and Craft Ventures.
Research & Design Org
Pave's R&D pillar includes our data science, engineering, information technology, product design, product management, and security teams. This organization builds, maintains, and secures a platform used by more than 8,500+ client organizations.
Our engineering team moves between ideation, scoping, and execution in a matter of days while closely iterating with cross‑functional partners on requirements. At Pave, we use TypeScript, Node.js, and React, hosted on GCP. Compensation strategy is broken down into three pillars - compensation bands, planning workflows, and total rewards communication. We build products that make these processes seamless for customers.
Over the next year, our roadmap is focused on enhancing the entire compensation lifecycle: from philosophy definition to market trend analysis, band adjustments, merit cycles, and employee communication. We're seeking passionate engineers who are excited about building robust, data‑rich systems that simplify complex compensation processes at scale.
The Data Team @ Pave
As part of the Data team at Pave, you will help us redefine how companies understand the labor market and determine compensation. Even the most innovative tech companies in the world often use spreadsheets full of flawed statistics to determine how to pay. At Pave, we've built a system of real‑time integrations that allow us to bring best practices from machine learning, data science, software tooling, and AI to an industry that is built on data, but doesn't have the tools it needs to fully leverage it.
What You'll Do
Architect and implement scalable ML systems for modeling compensation within a single company and across the market as a whole
Collaborate with product and engineering teams to identify additional opportunities to leverage ML‑driven solutions
Help evolve the technical direction of ML initiatives across the company
Drive millions of dollars of revenue growth
What You'll Bring
5+ years of experience building and deploying ML models in production environments
Strong foundation in machine learning, statistics, and deep learning fundamentals
Expertise in Python and modern ML frameworks (PyTorch, TensorFlow, or similar)
Experience with large‑scale data processing and ML model optimization
Experience with MLOps practices and tools (model versioning, monitoring, and deployment)
Strong software engineering practices and experience with production systems
Expert‑level SQL skills with experience writing complex queries and optimizing query performance
Ability to navigate (and bring structure to) ambiguity; ability to bring a project from 0 to 1, or scale a project from 1 to 100
Compensation
Salary is just one component of Pave's total compensation package for employees. Your total rewards package at Pave will include equity, top‑notch medical, dental, and vision coverage, a flexible PTO policy, and many other region‑specific benefits. Your level is based on our assessment of your interview performance and experience, which you can always ask the hiring manager about to understand in more detail. This salary range may include multiple levels.
The targeted cash compensation for this position is (level depends on experience and performance in the interview process):
P3: $195,000 - $215,000
P4: $230,000 - $250,000
Life @ Pave
Since being founded in 2019, Pave has established a robust global footprint. Headquartered in San Francisco's Financial District, we operate strategic regional hubs across New York City's Flatiron District, Salt Lake City, and the United Kingdom. We cultivate a vibrant, collaborative workplace culture through our hybrid model, bringing teams together in‑person on Mondays, Tuesdays, Thursdays, and Fridays to foster innovation and strengthen professional relationships.
Benefits
Complete Health Coverage: Comprehensive Medical, Dental and Vision coverage for you and your family, with plenty of options to suit your needs
Time off & Flexibility: Flexible PTO and the ability to work from anywhere in the world for a month
Meals & Snacks: Lunch & dinner stipends as well as fully stocked kitchens to fuel you
Professional Development: Quarterly education stipend to continuously grow
Family Support: Robust parental leave to bond with your new family
Commuter Assistance: A commuter stipend to help you collaborate in person
Vision & Mission
Our vision is to unlock a labor market built on trust.
Our mission is to build confidence in every compensation decision.
Equal Employment Opportunity
As set forth in Pave's Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law. If you believe you belong to any of the categories of protected veterans listed below, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.
#J-18808-Ljbffr
$230k-250k yearly 3d ago
Proposal Development Analyst
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Location: Remote (For Non-Local) or Hybrid (Local to NYC, Denver, or Charlotte)
Position Responsibilities:
Support RFP/RFI opportunities for new and renewal PBM opportunities with low to moderate complexity.
Comply fully with Capital Rx's policies and procedures for proposal development.
Support the creation and maintenance of consultant templates for assigned channel partners.
Create and refine SOPs to support RFP response development and submission working in collaboration with proposal managers and directors.
Within 9-12 months following hire date, demonstrate mastery of Capital Rx's products, services, and financial model to complete assignments with minimal oversight.
Comply with Capital Rx's time and attendance policies for all salaried employees, including working a base of 40 hours per week.
Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.
Support the management of the RFP response database by returning new and revised responses to the RFP Content Manager.
Assist in the creation and ongoing updates/edits to new RFP content.
Help obtain and catalog ancillary RFP samples and attachments.
Assist Content Manager with day-to-day maintenance of RFP library content (Qvidian).
Assist Content Manager with maintenance of SME list.
Contribute ideas for improvement across proposal & underwriting department including content management processes or tools.
Minimum Qualifications:
Undergraduate bachelor's degree, with record of strong academic performance in English, Journalism, Marketing or Communications
1+ years of proven experience in proposal writing, project management, or benefits consulting
Attention to detail & commitment to delivering high quality work product
Extremely flexible, highly organized, and able to shift priorities easily
Ability to lead multiple projects simultaneously and balance a range of key internal and external stakeholders
Track record of supporting multiple projects simultaneously, driving high performance, meeting deadlines, and executing on deliverables
Proficient in Microsoft Office, Adobe, and other editing software
Experience with RFP library software such as Qvidian, Loopio, Responsive, Expedience, etc. preferred
Knowledge of healthcare industry trends and best practices
Ability to write in plain language
Exceptional written and verbal communication skills, including technical copy editing
Passion for learning, including intricacies of pharmacy benefits products
Salary Range$75,000-$87,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$75k-87k yearly 2d ago
Clinical, Manager, Prior Authorization Technician
Capital Rx 4.1
New York, NY job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Location: Remote (For Non-Local) or Hybrid (Local to NYC area)
Position Responsibilities:
Oversee a dynamic team of pharmacy technicians engaged in the prior authorization process.
Analyze available data to provide prior authorization staffing, workflow, and system enhancement recommendations to maximize team agility and performance.
Actively participate in the prior authorization technician metric and quality goal setting process.
Generate and deliver comprehensive reports on prior authorization technician metrics to both internal and external stakeholders.
Assist the talent acquisition team in the hiring, evaluation, training, and onboarding of new employees.
Investigate/resolve escalated issues or problems from team members, clients, and other internal teams.
Key stakeholder in ensuring the prior authorization review platform is optimized for technician functions.
Maintain relationships with external Independent Review Organizations and clinical resource vendors.
Support the training and growth of both new and existing staff members in adherence to proper procedures.
Collaborate with prior authorization leadership to develop process improvements and support long-term business needs, recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and help establish best practices for conflict resolution while actively participating in problem identification and coordinate resolutions between appropriate parties.
Assists with in other responsibilities, projects, implementations, and initiatives as needed in accordance with the policies and procedures established within the department.
Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines.
Maintain compliance with local, state, and federal laws, in addition to established organizational standards.
Proactively obtains clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review.
Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions.
Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
Required Qualifications:
Active, unrestricted, National Certified Pharmacy Technician (CPhT) license required
Bachelor's or Associate's degree is preferred
4+ years of PBM or Managed Care pharmacy experience required
Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
Strong clinical background required
Excellent communication, writing, and organizational skills
Ability to multi-task and collaborate in a team with shifting priorities
Preferred Qualifications:
2+ years of regulated market prior authorization operations experience or knowledge of how to operationalize regulated market requirements
Previous prior authorization operations leadership experience
Salary Range$80,000-$90,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************
$80k-90k yearly 4d ago
Startup Insurance Advisor - Fast-Paced Growth
Vouch, Inc. 4.4
New York, NY job
A tech-enabled insurance advisory is seeking a knowledgeable Insurance Advisor to enhance client satisfaction during the sales and onboarding phase. The role requires 2+ years in a client-facing capacity, as well as a property and casualty license. Ideal candidates should be adaptable and possess excellent communication skills. The position is based in New York with a hybrid work model requiring in-office attendance three days a week. Competitive salary package, including equity options, is offered.
#J-18808-Ljbffr
$73k-96k yearly est. 2d ago
Professional, Overpayment Recovery and Monitoring Analyst
MVP Health Care 4.5
MVP Health Care job in Schenectady, NY
**Join Us in Shaping the Future of Health Care** At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team.
**What's in it for you:**
+ Growth opportunities to uplevel your career
+ A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team
+ Competitive compensation and comprehensive benefits focused on well-being
+ An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work For in the NY Capital District** , one of **the Best Companies to Work For in New York** , and an **Inclusive Workplace** .
You'll contribute to our humble pursuit of excellence by bringing curiosity to spark innovation, humility to collaborate as a team, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more vibrant communities.
**Qualifications you'll bring:**
+ Bachelor's degree in Health Administration, Business, Economics, Health Informatics, or related field. Associate's degree with the equivalent combination of related experience may also be considered.
+ Coding certification, such as AAPC CPC, CIC, COC, CCS is required.
+ The availability to work full-time, virtual in New York State
+ A minimum of three (3) years' experience in a professional coding environment and three (3) years' experience in auditing and/or reviewing in relevant healthcare industry experience.
+ Intermediate knowledge of provider reimbursement methodologies and all current coding methodologies.
+ Intermediate knowledge of Health Insurance and various plan types. Intermediate analytical, problem-solving skills and attention to details.
+ Ability to initiate education with providers and make internal recommendations for process improvements. Goals and outcomes of the recommendations and education must be measurable.
+ Curiosity to foster innovation and pave the way for growth
+ Humility to play as a team
+ Commitment to being the difference for our customers in every interaction
**Your key responsibilities:**
+ Manage recurring audit inventories, ensuring timely progression and completion of existing audits.
+ Identify and initiate new audits as patterns emerge through risk-based monitoring efforts, datamining, and other routine payment policy reviews.
+ Analyze new opportunities to substantiate, size, and prioritize audit needs, and develop audit protocols for new audit types.
+ Report suspected fraud and abuse to the SIU for further investigation and identify providers in need of education.
+ Collect and validate Key Performance Indicators (KPI's) from payment integrity functions across the organization.
+ Assist in the reporting of monthly metrics and participate in cross-functional audit operations.
+ Handle department projects, participate in committees relevant to payment integrity, and support process improvement efforts.
+ Participate in training and development activities within the department and corporation.
+ Perform other audit activities and manual reviews as requested, ensuring accuracy of claims and supporting overall payment accuracy.
+ Perform research using "best practices" in auditing methodologies, remaining current in CPC coding, reimbursement methodologies, MVP Policies and Procedures, and updates in professional literature.
+ Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.
**Where you'll be:**
Virtual within New York State
**Pay Transparency**
MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.
We do not request current or historical salary information from candidates.
$69,383.00-$92,279.00
**MVP's Inclusion Statement**
At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.
MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.
To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at ******************** .