MVP Health Care jobs in Tarrytown, NY - 6240 jobs

**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 ******************** .

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

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*********************************************

In this role, you will manage, investigate, and resolve assigned Property Contents Claims that present high exposure or more complex under limited supervision. You will inspect, compile and value inventory of damaged/lost contents associated with property claims and provide policyholders with exceptional customer service. You may assist Claims Representatives with in-person inspection/policyholder contact where necessary, and act as technical resource for other Contents Specialists. Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. Employees may apply for a new role after completing 12 months of employment in their current position. This is a field position and the ideal candidate must reside within the territories mentioned. Responsibilities: Handles a majority of large loss claims assigned under little supervision. Investigates, determines coverage of loss, and adjusts all elements of Property Loss claims of high severity. Performs full on-site inventory inspection and scope of damages and able to communicate such to both policyholders and vendors. Provides quality customer service. Provides insured with policy information to include coverage, limitations, and able to explain settlement effectively. Oversees coordination of contents vendors, some which are third-party -including contractors, emergency repair teams, and cleaning services, negotiates service scopes and estimates, monitors performance, and ensure compliance with contract terms and safety standards. May be asked to perform field assist on files handled by other property departments with in-person inspection and/or policyholder contact when needed. Takes initiative to stay current on personal‑property standards, market trends, and products through continuing education, seminars, and industry publications. Qualifications Strong written and oral communications skills required. Good interpersonal, analytical and negotiation skills required Effective negotiation skills. Customer service experience preferred Knowledge of coverages provided within various homeowner policies. Ability to effectively and independently manage workload while exhibiting good judgment. Experience in interior design, electronics, appliances, antique-collectibles, clothing and furniture retail preferred. The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience Ability to obtain proper licensing as required. Completion of advanced property training. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally.At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow.We are dedicated to fostering an inclusive environment where employees from all backgrounds can build long and meaningful careers. By actively seeking employee feedback and amplifying the voices of our seven Employee Resource Groups (ERGs), which are open to all, we create an environment where every individual can make a meaningful impact so we continue to meet the evolving needs of our customers.We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ****************************** Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco #J-18808-Ljbffr

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.

Network Adjusters is seeking skilled Bodily Injury Claims Adjusters to join our liability claims team. This role focuses on the investigation, evaluation, negotiation, and resolution of complex commercial bodily injury claims while delivering consistent, high-quality claims management in alignment with industry best practices. This position offers the opportunity to work within a trusted organization committed to integrity, reliability, and professional development through ongoing training and growth opportunities. About the Role Bodily Injury Claims Adjusters are responsible for managing commercial bodily injury claims from inception through closure. Claims may include complex commercial auto and general liability exposures with higher severity and specialization. In this role, you will investigate losses, analyze policy language, evaluate damages, negotiate settlements, and handle litigated matters while exercising a high level of independent judgment. Adjusters routinely take statements, review medical records and police reports, collaborate with legal counsel when necessary, and ensure all claim activity complies with state-specific regulations and Network Adjusters' quality standards and Best Claims Practices. This is a desk-based role. Responsibilities Handle complex Commercial Auto and General Liability bodily injury claims from inception to closure Investigate, evaluate, negotiate, and manage claims involving higher severity and exposure Provide superior customer service to insureds, claimants, carrier clients, and internal stakeholders Conduct comprehensive interviews, secure statements, and gather evidence from claimants, witnesses, medical providers, and law enforcement agencies Analyze insurance contracts and policy language to determine coverage applicability Review medical records, police reports, and related documentation to evaluate injuries and liability Establish, monitor, and adjust reserve requirements throughout the life of the claim Determine settlement values using independent judgment, applicable limits, deductibles, and collaboration with legal counsel when necessary Handle litigated matters and negotiate settlements within assigned authority Prepare professional written correspondence summarizing coverage analysis and claim decisions Communicate claim decisions and sensitive developments with clarity, confidence, and empathy Maintain accurate, up-to-date claim files, diaries, and documentation Ensure compliance with applicable regulations and Network Adjusters' quality standards and Best Claims Practices Qualifications Minimum 3 years of bodily injury claims handling experience Strong verbal and written communication skills Proficiency in MS Word, Outlook, Excel, and standard business software Strong customer service skills with demonstrated empathy Advanced analytical, investigative, negotiation, and decision-making abilities Excellent organizational and time management skills with the ability to manage complex workloads High attention to detail and commitment to accuracy Ability to maintain confidentiality College or technical degree, or equivalent business experience preferred Ability to obtain and maintain required adjuster licenses, including continuing education Knowledge of the security industry and/or rideshare industry is beneficial Bilingual proficiency preferred but not required Compensation & Benefits Salary: Starting from $75,000+ annually (based on licensure, certifications, and experience) Training, development, and career growth opportunities 401(k) with company match and retirement planning Paid time off and company-paid holidays Comprehensive medical, dental, and vision insurance Flexible Spending Account (FSA) Company-paid life insurance and long-term disability Supplemental life insurance and optional short-term disability Strong work/family and employee assistance programs Employee referral program Location 📍 Farmingdale, NY This role is on-site only; remote or hybrid arrangements are not available. About Network Adjusters Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver, and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.

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*********************************************

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*********************************************

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*********************************************

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: 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. 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$120,000-$175,000 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*********************************************

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.

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: This individual will report to the Associate Director of Clinical Program Business Development and be responsible for supporting the sales and profitability of Capital Rx's suite of clinical programs. This role serves as a primary business development lead for clinical offerings, from opportunity identification, client presentations, to negotiations and contracting. This role will drive clinical programs sales to new and existing PBM clients and foster strategic relationships with consultant groups. The ideal candidate will combine clinical expertise with strategic sales acumen to expand program adoption and deliver measurable value to clients. This is a base salary plus commission role. Position Responsibilities: Drive the sales strategy for Capital Rx's suite of clinical programs end-to-end from prospecting through close. Proactively assess client data to identify opportunities, meet with account teams to qualify opportunities, and deliver compelling presentations, proposals, and ROI analyses to prospects to drive clinical program sales. Develop and implement strategic plans to identify, engage, and close new clinical program opportunities. Cultivate and manage trusted relationships with pharmacy benefit consultant groups, serving as a subject matter expert for our clinical programs. Maintain a strong understanding of market dynamics, competitive landscape, and client needs to inform sales strategy. Contribute to strategic client retention initiatives by aligning clinical programs with client goals. Demonstrate strong analytical, presentation, and CRM skills to support sales execution and tracking. Maintain a deep understanding of clinical programs, regulatory requirements (e.g., CMS, NCQA, URAC), and industry trends to effectively position our solutions. Serve as a liaison between the field and internal product/clinical teams to ensure offerings remain competitive and relevant. Support implementation handoffs to ensure smooth onboarding of new clients. Provide market feedback to inform future product development and innovation. Support general business needs and operations, as required. All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Minimum Qualifications: MBA degree and/or certification in sales or business 3+ years of applicable experience in a health plan or PBM, or healthcare sales and/or completion of a PGY1 Clinical Pharmacy Residency Program, Managed Care Residency or Fellowship with additional 2+ years of applicable experience Exceptional negotiation, presentation, and communication skills with the ability to articulate clinical value propositions to diverse audiences. Experience engaging or partnering with pharmacy consultant firms Working knowledge of pharmacy benefit management, Medicare Part D, and commercial pharmacy benefits Ability to analyze data and market trends to inform sales strategy and client recommendations. Proven track record of meeting or exceeding sales targets and successfully closing complex B2B deals. Maintain an active, unrestricted pharmacy license in the state of residence Ability to balance multiple complex projects simultaneously with minimal direction Ability to travel up to 50% Preferred Qualifications: PharmD Experience working with HEDIS, Stars and PQA pharmacy quality measures Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint Experience with Confluence, Jira, Tableau Highly detail-oriented and analytical Visa Sponsorship: Capital Rx does not provide sponsorship to any candidates. This includes, but is not limited to those that require H1-B, TN, OPT, etc. Candidates must have authorization to work in the US at the time of application and throughout employment. 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$90,000-$140,000 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*********************************************

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*********************************************

**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 ******************** .

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

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*********************************************

Description: Why Join Marshall+Sterling? As a 100% employee-owned company with roots dating back to 1864, Marshall+Sterling offers the strength of a time-tested organization and the energy of an ownership-driven culture. Guided by our mission to empower clients to predict, prepare for, and preempt risk, we are relentlessly focused on helping people and businesses protect what matters most - so they can move forward with confidence. Our vision of creating a future that's safer and more secure drives everything we do. Innovation is not optional here - it's imperative. We constantly seek better, smarter ways to serve our clients and improve as a company. Collaboration is at our core, because we know we are stronger together - across teams, with our clients, and in the communities we serve. Our employee-owners are not only valued and empowered, but also directly invested in our collective success. At Marshall+Sterling, you're not just joining a company - you're joining a culture built on integrity, impact, and people-first values. Your ideas matter, your growth is prioritized, and your work helps shape a more secure future for all. This role is based in our Poughkeepsie Office. Join our Finance team and provide administrative and financial support across the organization. You'll manage daily accounting tasks, assist with month-end and year-end processes, and ensure accurate financial records. This role offers the opportunity to collaborate with a supportive team, contribute innovative ideas, and make a meaningful impact on our success. Manage daily accounting and financial processes (payments, deposits, reconciliations) Record and track commissions Prepare and distribute financial reports Handle billing and invoicing, including resolving errors and coordinating collections. Support month-end and year-end processes (reconciliations, accruals, reporting) Assist with audits and compliance requirements Maintain accurate financial records and documentation Provide support to colleagues and contribute to projects as needed Build and maintain positive working relationships across the team Requirements: College degree preferred, high school diploma or equivalent required. Proficiency in AI tools and experience using systems such as ImageRight, Outlook, and other related platforms to enhance efficiency and streamline processes. Proficiency in Microsoft Office; experience with Vertafore is a plus. Strong interpersonal skills with the ability to work effectively with colleagues. Excellent verbal and written communication skills. Highly organized with strong attention to detail. Total Rewards Package: Compensation : $57,500-$62,500, based experience and education. Benefits : Comprehensive package including Medical, Dental, Vision, 401(k) with match, Generous Paid Time Off (PTO), thirteen paid holidays, company-paid life insurance for you and your dependents, employee assistance fund and programs, wellness perks, and more! Employee Stock Ownership Program As a 100% employee-owned company, Marshall+Sterling offers you the unique opportunity to build long-term wealth while growing your career. Here's what makes our ESOP so valuable: Long-Term Rewards: The value of your ESOP account grows over time, rewarding your commitment and contributions to the company's success. Collaborative & Engaged Culture: Employee ownership fosters a team-oriented environment where everyone has a stake in the company's growth and success. No Out-of-Pocket Costs: Unlike stock purchase plans, our ESOP is entirely company-funded, meaning you gain equity without any personal investment. For more information on our culture and benefits, please visit us at : Careers -Marshall+Sterling MS24 Compensation details: 0 Hourly Wage PI3899b71800d8-4680

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 or Denver, CO) Position Summary: We are seeking a highly motivated and talented Data Engineer to join our team and play a critical role in shaping the future of healthcare data management. This individual will be a key contributor in building robust, scalable, and accurate data systems that empower operational and analytics teams to make informed decisions and drive positive outcomes. Position Responsibilities: Lead relationship with operational and analytics teams to translate business needs into effective data solutions Architect and implement ETL workflows leveraging CapitalRx platforms and technologies such as Python, dbt, SQLAlchemy, Terraform, Airflow, Snowflake, and Redshift Conduct rigorous testing to ensure the flawless execution of data pipelines before production deployment Identify, recommend, and implement process improvement initiatives. Proactively identify and resolve data-related issues, ensuring system reliability and data integrity Lead moderately complex projects. Provide ongoing maintenance and support for critical data infrastructure, including 24x7 on-call availability Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Required Qualifications: Bachelor's degree in Computer Science, Information Technology, or a related field 2+ experience working with Airflow, dbt, and Snowflake Expertise in data warehousing architecture techniques and familiarity with Kimball methodology Minimum 3+ years experience with a proven track record as a Data Engineer, displaying the ability to design, implement, and maintain complex data pipelines 1+ year experience in Python, SQL Capacity to analyze the company's broader data landscape and architect scalable data solutions that support growth Excellent communication skills to collaborate effectively with both technical and non-technical stakeholders A self-motivated and detail-oriented individual with the ability to tackle and solve intricate technical challenges Preferred Qualifications: 1-3 years of experience as a Data Engineer, ideally in the healthcare or PBM sector Advanced proficiency with Airflow, dbt, and Snowflake, coupled with 3+ years of SQL development and Python experience This range represents the low and high end of the anticipated base salary range for the NY-based position. The actual base salary will depend on several factors such as experience, knowledge, and skills, and if the location of the job changes. 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$120,000-$140,000 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*********************************************

**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 ******************** .