MVP Health Care jobs in Schenectady, NY

Qualifications you'll bring: Bachelor's Degree in Business, Math, Computer Science, Information Systems, related field or five or more years of related work experience. Master's degree preferred. Minimum 3 years of analytics experience with large data sets required 1 year of analytics experience with healthcare quality data highly preferred Subject matter expertise in healthcare data- claims, coding, HIE's etc. Experience with quality metrics, (NCQA HEDIS and NYS QARR) standards strongly preferred Strong analytical skills, with the ability to turn data into actionable insights Proficiency in SQL, data visualization tools (e.g. Tableau, PowerBI) Data Manipulation tools (e.g. Alteryx, R, Python) beneficial Excellent verbal and written communication skills, with the ability to effectively communicate technical information to both technical and non-technical stakeholders Intermediate Excel skills include entering and editing complex formulas, filtering lists, sorting ranges, and using data analysis tools (pivot tables, scenarios, etc.) 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 oversee the successful execution of quality data deliverables. Conduct analysis of large data sets to support quality improvement initiatives, including gap analysis, process optimization, and patient engagement. Collaborate with cross-functional teams to design, implement, and maintain data solutions that meet the needs of stakeholders and business partners. Ensure the accuracy and integrity of data through the development and implementation of data quality control processes and procedures. Must also provide adequate documentation of how analysis was performed and be responsible for applying necessary checks and balances to ensure quality and accuracy of reports. Participate in the development of data governance policies, standards, and procedures, and ensure compliance with regulatory requirements and industry best practices. Present data insights and recommendations to leadership, effectively communicating complex technical information to non-technical stakeholders using visual aids (charts, graphs) or summaries. Continuously monitor and evaluate the effectiveness of operational workflows, making recommendations for improvements and leading implementation efforts as necessary. 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 in NYS

Qualifications you'll bring: High school diploma Two years' experience in health insurance, medical, or healthcare field One year customer service experience The availability to work full-time, 3 days during the week and weekends required, virtually within NYS. Knowledge of Microsoft Outlook and Word Intermediate computer/keyboarding skills 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: Handle service requests and correspondences from providers, facilities, enrollees, or their representatives via phone, fax, email, and postal mail. Review and interpret authorization requirements based on MVP contracts, riders, resources, policies, and procedures. Create authorization cases for service requests requiring authorization. Make outgoing faxes and/or calls to providers with determinations or to request additional information. 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. Tarrytown, New York; Schenectady, New York; Rochester, New York

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a **Leader, Quality Analytics Operations** to join #TeamMVP. This is the opportunity for you if you have a passion for health equity, strategic engagement, and driving operational excellence. **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** . **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 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. **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 ******************** . **Job Details** **Job Family** **Medical Management/Clinical** **Pay Type** **Salary** **Hiring Min Rate** **121,767 USD** **Hiring Max Rate** **135,000 USD**

Qualifications you'll bring: BFA or a BA/BS in Graphic Design, Marketing, Advertising, Communications or other relevant field preferred, or Associates Degree in Graphic Design with a portfolio or comparable work experience. The availability to work full-time, hybrid. Minimum of 6-8 years' experience designing print and digital assets in a corporate setting, with health care industry experience a plus. Ideal candidate will have experience as an in-house designer or at an ad agency designing for both business-to-business and business-to-consumer audiences. Work samples are required to apply for this position. 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: Design and develop a wide range of media including brochures, flyers, posters, ads, signage, direct mail, and digital assets (web, email, social media, presentations). Contribute to concept development and marketing design strategies that support member communications and acquisition/retention efforts. Champion the MVP Brand Guidelines to ensure every piece reflects a consistent look, tone, and feel. Stay current with design software and digital trends, embracing new tools and ways of working. Collaborate with internal teams and external vendors to manage projects from concept to completion - on time and on point. 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 position, living within 50 miles from State Street in Schenectady or Rochester, NY.

Qualifications you'll bring: A Bachelor's degree in a relevant field or equivalent combination of education and experience. At least 3+ years of enterprise-level content management experience. Advanced proficiency in HTML, CSS, JavaScript, and experience with CMS platforms like Sitecore. Familiarity with SEO, CRO, UX/UI principles, and digital analytics tools (GA4, Tag Manager, SEMrush). Experience with email marketing and automation using Microsoft Dynamics. 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 stakeholder requests through ticketing systems like Microsoft Lists, Azure DevOps, and Jira. Update and maintain website content using Sitecore CMS, ensuring accuracy and brand alignment. Collaborate with internal SMEs to publish and optimize web content. Monitor and improve site performance using GA4, Tag Manager, Pagespeed Insights, and SEMrush. Support A/B testing initiatives and conversion rate optimization strategies. Build email and outbound campaigns using Microsoft Dynamics. Identify and resolve front-end issues including broken links and accessibility concerns. Apply HTML, CSS, and JavaScript to enhance usability and user experience. Collaborate cross-functionally with Development, IT, and other teams for timely updates. Maintain documentation of web processes and technical fixes. 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 Rochester or Schenectady, NY

Qualifications you'll bring: High School Diploma or GED required; Associate's degree in Business or related field preferred. The availability to work full-time, virtual, in Schenectady or Rochester, NY 1-2 years of data entry or claims experience preferred. High accuracy and attention to detail. Strong data entry skills (5,000-7,000 keystrokes per hour preferred). Proficiency in Microsoft Word and Excel. Familiarity with medical terminology. 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: Perform continuous data entry of claim forms into internal systems from electronic images and paper documents. Manage and update non-par provider demographic information, including provider-initiated changes. Load new providers and maintain existing provider records in systems such as Facets and Macess. Ensure compliance with regulatory claim payment timeframes. Collaborate with internal departments to resolve data discrepancies and support provider data integrity. Maintain confidentiality and adhere to HIPAA and other regulatory standards. Meet or exceed departmental standards for productivity and quality. Adapt to changing business needs, including occasional overtime. 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 in Schenectady, NY or Rochester, NY

Qualifications you'll bring: Bachelor's degree of applicable study with minimum of 3 years of experience in Health Care Analytics role or Advanced degree in math or statistics, and at least 1 year of experience working with Health Care data Working knowledge of Provider Billing/Reimbursement methodologies Foundational knowledge of MVP's markets and products and awareness of competitive landscape Working knowledge of MVP Data assets including claim, pharmacy, member and provider data Proficiency in SQL and Microsoft suite of products including Power Platform 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: Collaboration with team leader, peers and key stakeholders across the organization Research and query multiple data sources, manipulate large sets of data using appropriate tool Identify and implement the most efficient solution for the business problem with forward thinking mindset to leverage automation and efficiency Leverage AI, Machine Learning or Statistical software where appropriate to advance analytics Validation of data, data models and reporting for accuracy and soundness Actively seek to draw inferences from the data to drive actionable insights/strategic discussions Actively seek to understand the why and how to add value to business request vs. just doing the request Actively challenge the status quo and find a better way 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: Location: remote within New York State

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a **Professional, Behavioral Health** to join #TeamMVP. If you have a passion for healthcare, improving access to care, enhancing quality and compliance this is the opportunity for you. **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** . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and substance use treatment decisions. This individual will make triage and referral decisions requiring clinical judgement, with an emphasis placed on Autism Spectrum Disorders (ASD) and Applied Behavior Analysis (ABA). This role will also provide care coordination to support members in meeting their behavioral health needs. **Qualifications you'll bring:** + Master's prepared and licensed mental health clinician (LMSW, LCSW, LMHC, etc.) or Licensed Registered Nurse (RN) required + New York State license required + Licensed Behavior Analyst (LBA) or Board-Certified Behavior Analyst (BCBA) preferred. If possessing an LBA, another clinical license is not required. + Willingness and ability to obtain equivalent license in Vermont + Minimum of 3 years of direct clinical practice (mental health and/or substance use) with children and/or adolescents, with at least 2 years being ASD related + Utilization or Case Management experience in a managed care organization is preferred + Knowledgeable with diagnosis and procedural coding preferred + Detail oriented with strong organizational skills including the ability to manage time wisely to meet established deadlines. + Ability to make independent decisions regarding resource utilization, and quality of care. + Must demonstrate understanding of clinical and psychosocial issues that may alter treatment or care plan and be able to demonstrate good judgment when dealing with emotionally charged situations. + 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:** + Review all requests for behavioral health services utilizing the appropriate behavioral health and MVP standards and criteria tools, including MVP Health Care Medical Policy, Change Health Care's InterQual Criteria, the New York State Office of Addictions Services and Supports Level of Care (OASAS) for Alcohol and Drug Treatment Referral (LOCADTR) tool, and other guidelines provided by the states of New York and Vermont. + Conduct prospective, concurrent, and retrospective reviews in adherence with MVP, state, federal, and accreditation guidelines and rules. + Provide care management and coordination for MVP customers to assess, plan, implement, coordinate, monitor, and evaluate options and services required to meet an individual's behavioral health needs. + Collaborate with internal and external stakeholders to support coordination of services across behavioral health, medical, and social domains. + Consult with Leadership, Behavioral Health Medical Directors, and an integrated team of physicians and clinicians, on challenging and high-risk cases. + Maintain accurate and timely documentation in compliance with regulatory standards. + Participate in quality improvement initiatives and team meetings. + Responsible for making triage and referral decisions requiring clinical judgement, with an emphasis placed on Autism Spectrum Disorders (ASD) and Applied Behavior Analysis (ABA). + 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 in NYS **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. **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 ******************** . **Job Details** **Job Family** **Medical Management/Clinical** **Pay Type** **Salary** **Hiring Min Rate** **56,200 USD** **Hiring Max Rate** **98,000 USD**

Qualifications you'll bring: Associate's or Bachelor's degree in a related field (e.g., healthcare administration, business, or HR) preferred. 2+ years of experience in credentialing, compliance, or quality assurance. Experience in healthcare or insurance credentialing preferred. Strong attention to detail and analytical skills. Familiarity with credentialing software and databases. Knowledge of regulatory standards (e.g., NCQA, URAC, Joint Commission) is a plus. Excellent communication and organizational skills. Ability to work independently and collaboratively in a fast-paced environment. Proficiency in Microsoft Office Suite (Word, Excel, Outlook). Understanding of data privacy and confidentiality standards. 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: Conduct thorough quality control reviews of credentialing/recredentialing files and documentation. Verify credentials, licenses, certifications, and other required documentation for accuracy and compliance. Collaborate with credentialing specialists to resolve discrepancies and ensure timely updates. Maintain detailed records of QC findings and corrective actions. Assist in developing and refining QC procedures and checklists. Monitor compliance with internal policies, accreditation standards, and regulatory requirements. Provide feedback and training to credentialing staff on quality standards and best practices. Support audits and reporting requirements related to credentialing activities. Stay current with industry standards, regulations, and credentialing best practices. 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

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a **Health Care Sales Enroller** to join **\#TeamMVP** . This is an opportunity to dive into a role where your passion for community outreach, strategic engagement, and your love for your community can flourish. **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** . **Qualifications you'll bring:** + Two or more years in a customer service or sales environment, with some experience in the health care industry such as a hospital, medical office, or health insurance company. + The ability to speak more than one language preferred (for example, English and Bengali, Hindi an/or Spanish). + An Associate degree or equivalent combination of education and related experience. + The availability to work full-time, virtual with daily local travel (some evening and weekend hours required). + Must have a valid driver's license. + 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:** + **Spearhead our membership growth initiatives in crucial target areas** by identifying eligible individuals and seamlessly enrolling them in a variety of plans including Medicaid, Child Health Plus, Essential Plan, Qualified Health Plans (QHPs), HARP, Off-Exchange, Medicare Advantage (MA) products, and Dual Eligible Special Needs Plans (D-SNP). + **Conduct both individual and group outreach activities** to present our innovative health care solutions on- and off-site at various events-from health fairs and community expos to festivals and holiday-themed gatherings-ensuring MVP's presence is both seen and felt. Your collaborative efforts alongside our Field Marketing and Community Engagement Representatives will be pivotal in driving growth and visibility in assigned territories. + **Foster positive relationships** with community-based organizations, medical provider partners, and community contacts to develop a robust network within your territory. + **Generate, track, and convert qualified leads** and referrals into MVP customers. + **Lead two monthly events** that highlight our progressive health solutions directly to the communities we serve, strengthening ties and enhancing our brand's impact. + **Navigate the local landscape with required travel** , embracing the opportunity to bring MVP's customer-centric philosophy to life across our footprint. + **Participate in necessary screenings and provide proof of immunization** as part of our commitment to community well-being. + **Demonstrate the dynamic capability** to transport up to 30 lbs. of promotional materials, which play a key role in educating and empowering our customers about their health care choices. + **Contribute to our humble pursuit of excellence by performing various responsibilities** that may arise, reflecting our collective goal of enhancing health care delivery and being the difference for the customer. **Where you'll be:** + Remote with local travel (this role is salary plus incentive and travel reimbursement) \#CS **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. **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 ******************** . **Job Details** **Job Family** **Outreach** **Pay Type** **Hourly** **Travel Required** **Yes** **Travel Percentage** **75** **Hiring Min Rate** **59,000 USD** **Hiring Max Rate** **64,000 USD**

Qualifications you'll bring: Bachelor's Degree preferred; equivalent experience may be substituted if the candidate can demonstrate significant relevant work experience. Minimum of 5 years in health insurance or equivalent experience in Finance or Project Management. Strong proficiency in problem solving and analysis Ability to use Microsoft Office and Power Point Proficiency in Excel. Must be able to manipulate pivot tables, utilize mathematical formulas, filter data, etc. Excellent presentation skills Proficiency in financial impact analysis 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: Coordinates with Analytics Team to generate performance reporting and associated financial models. Assists Leaders in leveraging of competitive transparency data during contract negotiation and annual performance reviews. Assists with developing contract documents for renewals and/or amendments in compliance with company templates, reimbursement structure standards and other key process controls. Supports the business relationships with Hospital, Physician and Ancillary Facilities. Maintains an inventory of contracts, due dates, term clauses/end dates, spend and services by LOB. Requests necessary data analytics from Informatics to support key business objectives and product objectives where contracting is involved. Keeps and maintains necessary database trackers and a tracking system for department and MVP report outs. Processes forms, tracks and scans signed/executed agreements and amendments. Serves as the primary point of contact for day-to-day issues such as payment issues, authorization issues and contractual language interpretation disputes. Ability to maintain confidentiality and adhere to regulatory compliance issues as they exist and change from time to time. Proactive in identifying areas for efficiency improvement across all of Network Management; consistently challenges the status quo in favor of incremental improvement opportunities that could be achieved through new methods. 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: Location: Hybrid to Schenectady, NY or Fishkill, NY

Qualifications you'll bring: High School diploma or equivalent when possesses customer service employment experience. Minimum 1 - 3 years customer service experience and/or relevant office experience required. Availability to work Monday- Friday from 8:30am- 5:00pm Strong problem-solving skills with effective oral and written communication skills Have strong interpersonal skills and exhibit good judgment Demonstrated excellent customer service skills including superior accountability and follow through Demonstrated PC skills using Microsoft applications 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: The Associate, Provider Member Service Representative is responsible for responding to all Department of Health audit calls on a consistent basis. Acts as a liaison between our internal and external customers. Responds promptly, accurately, and effectively to all calls in a polite and professional manner. Responds to all calls timely and have a clear understanding of call avoidance, such as but not limited to short calls, intentional disconnects, inappropriate transfers and inappropriate use of hold button. Performs data input in a highly accurate and timely manner on all customer contacts. Simultaneously accesses multiple databases while addressing customer's needs. Clearly explains all policies and procedures on both incoming and out-going calls. Develops a comprehensive understanding of all lines of business. Has the technical skills required to be able to perform task efficiently. Delivers information in a clear and confident manner 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: Location: Virtual. Please note all candidates must be located in New York State within a 40- mile radius from the Schenectady, NY; Rochester, NY; Tarrytown, NY

At MVP Health Care, we're on a mission to create a healthier future for everyone which requires innovative thinking and continuous improvement. To achieve this, we're looking for an Overpayment Recovery and Monitoring Analyst to join #TeamMVP. If you have a passion for managing audits, medical coding, and analytical thinking and this is the opportunity for you. **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 and one of the **Best Companies to Work For in New York** **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 \#cs **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. **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 ******************** . **Job Details** **Job Family** **Legal** **Pay Type** **Salary** **Hiring Min Rate** **56,200 USD** **Hiring Max Rate** **82,000 USD**

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for an **Associate, Post-Acute Clinical Support Specialist** to join #TeamMVP. If you have a passion for enhancing patient care, supporting healthcare teams and accuracy and compliance this is the opportunity for you. **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** . **Qualifications you'll bring:** + High school diploma or equivalent required + Minimum of 3 years' current experience in healthcare setting or a related field required + Strong attention to detail and ability to manage multiple tasks simultaneously. + Excellent communication skills, both written and verbal. + Exceptional customer service skills and ability to handle difficult situations with empathy and professionalism. + Proficient in using computer systems and software, including Microsoft Office Suite. + Ability to work independently and as part of a team in a fast-paced environment. + Strong organizational and time management skills. + Knowledge of medical terminology and healthcare documentation standards + 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:** + Provide administrative and operational support for post-acute care program. + Coordinate communication between internal teams, skilled nursing facilities, inpatient rehabilitation facilities, and home health agencies. + Work closely with internal and external stakeholders to support clinical documentation, ensuring accuracy and compliance with organizational and regulatory requirements. + Assist with data entry, reporting, and tracking patient transitions and utilization metrics. + Review documentation for completeness ensuring compliance (e.g.: CMS, Medicaid, NCQA). + Support quality improvement initiatives and process enhancements. + Serve as a resource for post-acute workflows and escalate issues as needed. + Other duties as assigned. + 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 in NYS **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. **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 ******************** . **Job Details** **Job Family** **Medical Management/Clinical** **Pay Type** **Hourly** **Hiring Min Rate** **28.8 USD** **Hiring Max Rate** **33.12 USD**

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a **Enterprise Sr. Program Manager** to join #TeamMVP. If you have a passion for collaboration, innovation, and customer-centric outcomes, this is the opportunity for you. **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** . **Qualifications you'll bring:** + Bachelor's degree in Business, Healthcare Management, or related field. Relevant project/program management certifications such as PMP, PgMP, Scrum, PMI-ACP, and SAFe is a plus. + A minimum of 5 years of experience in project/program management, preferably in healthcare or technology. Proven experience with managing large-scale transformation initiatives and strong knowledge and experience with Agile delivery methodologies. + Strong written and verbal communication skills, including the ability to facilitate meetings, effectively lead discussions, and prepare/deliver presentations for internal/external audiences. + Ability to thrive in an entrepreneurial environment: a curiosity and eagerness to solve big challenges and ability to manage projects independently. + Ability to build and maintain effective working relationships with all levels of management and staff. + Deep understanding of organizational change management. + Strong results-oriented team player with a passion for driving cross functional collaboration. + Excellent organizational skills and ability to work independently. + Self-starter with a high degree of initiative and follow through. + Advanced analytical and problem-solving skills to prioritize work and resolve issues using sound judgment to improve processes and drive change. + Skilled in decision making, conflict resolution, and risk mitigation. + Capable of transferring knowledge to existing staff. + Deep experience with Microsoft Office and project management tools. + Complies with company ethics policies. + 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:** **Team Leadership:** + Lead and manage cross-functional teams to achieve program goals, fostering collaboration, communication, and a sense of ownership among team members. + Foster a collaborative and high-performance team environment focused on continuous improvement. + Provide oversight and support to project managers and teams working within their programs. + Ensure project teams are adhering to processes and standards set by the SOC. **Program Planning and Execution:** + Develop comprehensive program plans outlining scope, objectives, deliverables, roadmaps, timelines, and resource requirements in alignment with stakeholder expectations. + Lead the execution of program plans, ensuring alignment with OKRs. + Coordinate with cross-functional teams to ensure seamless integration and execution of program activities. **Monitoring and Reporting:** + Establish and maintain program performance metrics and KPIs. + Monitor progress against program plans, identifying and addressing deviations. + Monitor program and project budgets and forecasts. + Prepare and communicate regular progress updates to senior management and stakeholders. **Risk and Issue Management:** + Identify, assess, and manage program risks and issues. + Develop and implement mitigation strategies to minimize impact on program objectives. + Maintain a RAID log, ensuring timely resolution and escalation as needed. **Dependency Management:** + Identify and manage interdependencies between program initiatives and other organizational projects. + Ensure effective communication and coordination to mitigate potential conflicts and delays. **Agile Methodologies:** + Apply agile principles and practices to program management. + Foster a culture of continuous improvement and adaptability within the program team. **Stakeholder Engagement:** + Build and maintain strong relationships with key stakeholders, including senior management, team members, vendors, and other stakeholders. + Ensure clear and consistent communication of program goals, progress, and challenges. **Project Management:** + In addition to program management, program managers may be asked to manage projects if the need arises. 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 to 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. **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 ******************** . **Job Details** **Job Family** **Customer Service** **Pay Type** **Salary** **Hiring Min Rate** **121,767 USD** **Hiring Max Rate** **150,000 USD**

Qualifications you'll bring: Two or more years in a customer service or sales environment, with some experience in the health care industry such as a hospital, medical office, or health insurance company. The ability to speak more than one language preferred (for example, English and Bengali, Hindi an/or Spanish). An Associate degree or equivalent combination of education and related experience. The availability to work full-time, virtual with daily local travel (some evening and weekend hours required). Must have a valid driver's license. 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: Spearhead our membership growth initiatives in crucial target areas by identifying eligible individuals and seamlessly enrolling them in a variety of plans including Medicaid, Child Health Plus, Essential Plan, Qualified Health Plans (QHPs), HARP, Off-Exchange, Medicare Advantage (MA) products, and Dual Eligible Special Needs Plans (D-SNP). Conduct both individual and group outreach activities to present our innovative health care solutions on- and off-site at various events-from health fairs and community expos to festivals and holiday-themed gatherings-ensuring MVP's presence is both seen and felt. Your collaborative efforts alongside our Field Marketing and Community Engagement Representatives will be pivotal in driving growth and visibility in assigned territories. Foster positive relationships with community-based organizations, medical provider partners, and community contacts to develop a robust network within your territory. Generate, track, and convert qualified leads and referrals into MVP customers. Lead two monthly events that highlight our progressive health solutions directly to the communities we serve, strengthening ties and enhancing our brand's impact. Navigate the local landscape with required travel, embracing the opportunity to bring MVP's customer-centric philosophy to life across our footprint. Participate in necessary screenings and provide proof of immunization as part of our commitment to community well-being. Demonstrate the dynamic capability to transport up to 30 lbs. of promotional materials, which play a key role in educating and empowering our customers about their health care choices. Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing health care delivery and being the difference for the customer. Where you'll be: Remote with local travel (this role is salary plus incentive and travel reimbursement) #CS

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a **Desktop Support Services Internship** to join #TeamMVP. This is the opportunity for you if you have a passion for troubleshooting, growth, and technology. **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** . **Qualifications you'll bring:** + Must be enrolled in a Computer Science, Information Systems, or a technically equivalent undergraduate degree program or equivalent military experience. + Basic hardware + Windows 10\11 + Office365 + Software skills + Troubleshooting skills. + Ability to multi-task and work within time constraints. + Ability to work collaboratively. + Critical thinking + Problem-solving skills. + 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:** + Installation and maintenance of personal computers and including all peripheral equipment. + Installation and configuration of personal computers and printers (network and desktop). + Diagnosing computer and network problems on-site or by assisting help desk staff with user telephone consultations. + Upgrading of computers and peripheral equipment. + Receipt and distribution of new computer equipment. + Tests new operating systems and software titles for interoperability and functionality with existing systems and software. + Good knowledge of modern personal computers and local area networks. + Good knowledge of installation procedures relating to personal computers, local area networks, peripheral equipment and software. + Ability to install office computer systems. + Ability to work with remote users with different remote tools. + May perform other related duties as required. + 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:** Location: Onsite; 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. **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 ******************** . **Job Details** **Pay Type** **Hourly** **Hiring Rate** **18 USD**

Qualifications you'll bring: Bachelor's degree in Business, Healthcare Management, or related field. Relevant project/program management certifications such as PMP, PgMP, Scrum, PMI-ACP, and SAFe is a plus. A minimum of 7 years of experience in project/program management, preferably in healthcare or technology. Proven experience with managing large-scale transformation initiatives and strong knowledge and experience with Agile delivery methodologies. Strong written and verbal communication skills, including the ability to facilitate meetings, effectively lead discussions, and prepare/deliver presentations for internal/external audiences. Ability to thrive in an entrepreneurial environment: a curiosity and eagerness to solve big challenges and ability to manage projects independently. Ability to build and maintain effective working relationships with all levels of management and staff. Deep understanding of organizational change management. Strong results-oriented team player with a passion for driving cross functional collaboration. Excellent organizational skills and ability to work independently. Self-starter with a high degree of initiative and follow through. Advanced analytical and problem-solving skills to prioritize work and resolve issues using sound judgment to improve processes and drive change. Skilled in decision making, conflict resolution, and risk mitigation. Capable of transferring knowledge to existing staff. Deep experience with Microsoft Office and project management tools. Complies with company ethics policies. Curiosity to foster innovation and pave the way for growth. Humility to play as a team. Commitment to being the difference for our customer in every interaction. Your key responsibilities: Governance & Standards Support the Director of the PMO in developing and maintaining project management frameworks, methodologies, and governance processes. Ensure compliance with organizational standards across all projects. Portfolio & Performance Support Monitor project portfolio performance, tracking progress, risks, and dependencies. Prepare dashboards, reports, and recommendations for the Director and executive stakeholders. Strategic Alignment Collaborate with the Director to align projects with organizational priorities and strategic objectives. Provide analysis to support project prioritization and resource allocation decisions. Expert Guidance Act as a subject matter expert on project management tools, techniques, and best practices. Provide coaching and support to project managers and teams, without direct supervisory responsibility. Continuous Improvement Identify opportunities to enhance PMO processes, reporting, and efficiency. Recommend improvements to strengthen project delivery and organizational outcomes. 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

Qualifications you'll bring: Bachelor's degree in Marketing, Business, Communications, or related field; Master's preferred. Minimum of 10 years of experience in marketing, philanthropy, or community engagement roles. Proven leadership with 5 years experience with the ability to inspire and motivate a team. Strong understanding of field marketing strategies and community partnership development. Excellent communication and interpersonal skills. 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: Oversee all sponsorship programs, ensuring alignment with brand, organizational priorities, and community needs. Develop and execute field marketing strategies to increase brand awareness and engagement. Design and implement event activations that engage diverse audiences and effectively promote the MVP brand across all community touchpoints. Build and maintain strong relationships with community partners and stakeholders. Lead and oversee teams of dedicated professionals in field marketing sponsorship and engagement, providing guidance and support. Monitor and analyze the effectiveness of marketing impact, making data-driven decisions to optimize community presence. Collaborate with internal teams to ensure cohesive and effective communication of company initiatives. Represent the company at community events and activities across our footprint. Manage and oversee the field marketing and engagement budget, ensuring responsible allocation of resources and alignment with organizational priorities. Develop regular internal communications that promote field marketing activities and community presence. Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing health care delivery and being the difference for the customer. Where you'll be: Hybrid - based in Schenectady, NY, with travel across MVP's footprint for community events and activations.