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  • Schenectady, NY, US
    Req #81
    Monday, July 15, 2019
    Summary:This position is responsible for the design, installation, configuration, and documentation of the physical environment. They will be responsible for the build activities, maintenance and administration of the enterprise servers (physical and virtual) and storage architectures. This includes the placement of all the physical equipment such as servers, storage devices and required cabling. They will need to set up accounts on servers, configure the necessary backups and security software. ... More
  • Tarrytown Office
    Req #153
    Monday, July 15, 2019
    Associate, Senior Claims Examiner   Full-time, Non-Exempt Summary:   Provides feedback to the unit leader concerning the daily activities of each unit,ensuring that each unit is running effectively, and handling of priority issuesand claim projects in a timely manner. Acts as point person for each unit, andis responsible for receiving and responding to E-mail, internal and corporateservice forms, and phone inquiries from Member Services, Provider Relations,and all applicable regional offices ... More
  • Headquarters Office
    Req #179
    Friday, July 12, 2019
    Associate, Provider Services, Care Center RepresentativeStatus: Full-time, Exempt: No       Summary: Responsible to address member/subscriber/provider inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Majority of contact is via telephone, with some in-office contact and written correspondence/e-mail as needed. Position handles a variety of insurance types including HMO, POS, PPO, ASO, Inde ... More
  • Tarrytown Office
    Req #178
    Wednesday, July 10, 2019
    MVP seeks a Business Intelligence Engineer for our Tarrytown, New York location.  Responsibilities include: use SQL Server to design and build database for big ETL projects.  Development of new ETL processes as required by organizational needs, report design, creation, implementation and execution of final solution.  Responsible for maintaining, troubleshooting, and modifying existing ETL projects and reports ensuring aclean turnover of a developer’s product from development to test, from test t ... More
  • Headquarters Office; Rochester Office
    Req #174
    Wednesday, July 10, 2019
    Professional, Marketing & Communications   SUMMARY:    MVP Health Care is seeking an experienced Marketing &Communications professional to join our team. We are looking for anenthusiastic, creative and driven individual to provide marketing andcommunication expertise to the business. The ideal candidate will need to havea strong understanding of traditional and digital marketing tactics with provenproject management skills. You will: Partner in the planning, development and implementa ... More
  • Headquarters Office
    Req #168
    Wednesday, July 10, 2019
    Associate, Accounts Payable, APStatus: Full-time, Non-ExemptSummary: Responsible for weekly processing of administrative trade accounts payable check runs for all corporate entities of MVP Health Care. Gathers completed check requests and verifies for coding propriety. Responsible for printing checks weekly and preparing checks for mailing or internal distribution. Answers employee and outside vendor inquiries for vendor payment history or payment status of invoices. Enters check requests in bat ... More
  • Rochester Office
    Req #172
    Wednesday, July 10, 2019
    Associate, Provider Services, Care Center Representative Status: Full-time, Exempt: No         Summary: Responsible to address member/subscriber/provider inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Majority of contact is via telephone, with some in-office contact and written correspondence/e-mail as needed. Position handles a variety of insurance types includin ... More
  • Headquarters Office
    Req #171
    Wednesday, July 10, 2019
    Associate, Commercial Services, Care Center Representative  Status: Full-time, Exempt: No     Summary: Responsible to address member/subscriber/provider inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Majority of contact is via telephone, with some in-office contact and written correspondence/e-mail as needed. Position handles a variety of insurance types including HMO, ... More
  • Rochester Office
    Req #165
    Wednesday, July 10, 2019
    Status: Full-time, Exempt: No         Summary: Responsible to address member/subscriber/provider inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Majority of contact is via telephone, with some in-office contact and written correspondence/e-mail as needed. Position handles a variety of insurance types including HMO, POS, PPO, ASO, Indemnity, NY and VT Exchange plan ... More
  • Binghamton Office; Headquarters Office; Utica Office
    Req #164
    Tuesday, July 9, 2019
    Status: Full-time, Exempt: Yes This position supports the team that negotiates and manages contractual arrangements with the health plan’s participating behavioral health and substance abuse facilities and regional hospitals, hospital systems, and certain medical groups. Responsibilities include managing logistics of the provider contract process and preparation of standard and ad-hoc analyses / reports in support of contract and pricing initiatives. Provider contracting responsibilities inclu ... More
  • Headquarters Office
    Req #163
    Tuesday, July 9, 2019
    Status: Full-time, Exempt: Yes     Summary:This role will provide support to the company in performing necessary day-to-day Actuarial tasks. Assistsin premium rate development for MVP’s blocks of business. Develops, refreshes and analyzes financialforecasts and projections. Reviews actuarial models used to project future claim liabilities. Works toanalyze MVP’s financial statements. Analyzes and refines current methodologies used for premium ratedevelopment and reserving. Performs other ... More
  • Headquarters Office; Rochester Office; Tarrytown Office
    Req #159
    Tuesday, July 9, 2019
       Full-time, Exempt: Yes   Summary: The Behavioral Health Leader provides professional oversight, leadership and guidance over the day-to-day operation of the Behavioral Health Care Management Team. Ensures the development, implementation, coordination, and evaluation of the Team’s job responsibilities. Develops and monitors productivity metrics. Performs quality checks, audits, coordinates interrater reliability activities, and supports the team in meeting their prod ... More
  • Headquarters Office
    Req #173
    Tuesday, July 9, 2019
    Status: Full-time, Exempt           Summary: This role will be responsible for the mapping the “as is state”, the “desired end state” and the steps necessary to evolve.  Will focus on process measurement, change management and optimization of MVP’s CRM processes across the enterprise.  Focus on research and development – enabling new technologies to enhance current business processes.  Assures new processes and sub-processes integrate appropriately w ... More
  • Tarrytown Office
    Req #145
    Monday, July 8, 2019
    Associate, Outreach Representative    The Outreach Representative conducts individual and group Field Outreach activities throughout their regions; promotes MVP throughout their regions, and conducts public presentations on MVP products. The Outreach Representative must provide fair and impartial information to individual Marketplace customers regarding coverage options available through the NY State of Health Marketplace. They help facilitate enrollment in Qualified Health Plans (QHPs), insuran ... More
  • Newburgh Office
    Req #143
    Monday, July 8, 2019
    Leader, Community Based Outreach Staff RESPONSIBILITIES:Responsible for Leading field staff that report out of the local retail offices, this includes,main offices, satellite offices, community based locations, community outreachvehicle locations, and other areas where we meet with potential clients. Responsiblefor overseeing Outreach and promotion of the Plan’s Medicaid, Child Health Plus(CHP), Essential Plan and “on-exchange” Qualified Health Plans (QHP) toindividuals and community groups in t ... More
  • Tarrytown Office
    Req #152
    Monday, July 8, 2019
    The Professional, Special Services Liaison will be the liaison with external agencies to ensure coordination with the services they are providing to MVP Medicaid members. As liaison to county Foster Care Coordinators or Voluntary Foster Care Agencies, this role will act as primarycontact person to assist with enrollment, disenrollment, and access to care for the foster care children.This professional will work with MVP Care Managers, Foster Care Coordinator, hospitals, and/or Health Home Care Ma ... More
  • Rochester, NY, US; Schenectady, NY, US
    Req #149
    Monday, July 8, 2019
    This position will primarily support IT Audit, Compliance and Risk Management activities required to enable our organization to reach itsgoals. As part of the IT Governance team, the incumbent may also assist with governance initiatives in other areas. The role includes but is not limited to the following: Business Resilience– Working with business leaders and technology leaders, to prepare for disruptive events and keep the business operating as usual during a disaster. Specifically, develop ... More
  • Headquarters Office; Rochester Office; Tarrytown Office
    Req #162
    Wednesday, July 3, 2019
    Status: Full-time, Exempt: Yes This position will provide oversight, leadership and direction for the implementation of focused case and disease management interventions targeted to improve member and provider satisfaction, decrease cost waste, maximize quality and improve clinical outcomes.  Residency in NY is mandatory.  Responsibilities include but are not limited to: Development and support Care Management and Health Management Programs that are provider inclusive and member centric.  Suppo ... More
  • Headquarters Office; Rochester Office; Tarrytown Office
    Req #161
    Wednesday, July 3, 2019
     Status: Full-time, Exempt: YesThis role oversees the development, implementation, ongoing operations, assessment and monitoring of MVP Utilization Management programs. Residency in NY is mandatory.  Related responsibilitiesinclude but are not limited to: Responsible for the Clinical Care Management System updates and training.Analyzes and reports significant utilization trends, and patterns to appropriate departmental and medical staff committees.Hires, coaches, trains, and manages staff to ens ... More
  • Headquarters Office; Rochester Office; Tarrytown Office
    Req #160
    Wednesday, July 3, 2019
    Status: Full-time, Exempt: Yes     In collaboration with the Chief Medical Officer and other stakeholders, responsible for overseeing the development and implementation of behavioral health and integrated medical management strategies for:   Care Management ProgramsUtilization Management ProgramsIntegrated health model development (physical and behavioral health)Clinical integration with value-based purchasing opportunitiesAlignment of pharmacy with all clinical and non-clinical ... More
  • Headquarters Office
    Req #158
    Wednesday, July 3, 2019
    Status: Full-time, Exempt: Yes    Professional, Sr. Sales Exec Commercial  Develops sales strategies to achieve membership and revenue targets within the Large Group market. Maintains in-depth knowledge of: regional competition, including products, rates, underwriting guidelines and local/national health care trends. Understands basic field underwriting and risk selection. Acquires and maintains the maximum amount of knowledge about MVP products, lines of business, sales a ... More
  • Headquarters Office
    Req #148
    Wednesday, July 3, 2019
    Status: Full-time, Non-Exempt             Summary:       The Group EDI Associate is responsible for the coordination of all EDI enrollmentsand eligibility functions including but not limited to implementation,processing, reconciliation, and quality control. Identify any errors within theEDI process and coordinate with internal and external customers for resolution.The associate will work directly with internal and external customers. Ensure new EDI groups meet MVP’s current mapping proceduresto ... More
  • Headquarters Office; Rochester Office; Tarrytown Office
    Req #157
    Tuesday, July 2, 2019
    Status: Full-time, Exempt: Yes       Summary:In collaboration with the Chief Medical Officer and other stakeholders, assists with the development and implementation of behavioral health and integrated medical management strategies for the pediatric population including:Care Management ProgramsUtilization Management ProgramsIntegrated health model development (physical and behavioralhealth)Clinical integration with value-based purchasing opportunitiesAlignment of pharmacy with all ... More
  • Headquarters Office; Rochester Office; Tarrytown Office
    Req #156
    Tuesday, July 2, 2019
    Status: Part-time, Exempt: Yes      Provides clinical expertise and timely first and second level clinical determinations based on MVP’s policies/procedures, state and federal guidelines, national accreditation standards, benefits interpretations, and other medical necessity criteria as necessary. May conduct pediatric reviews. Supports’s MVP’s efforts to collaborate in person and virtually with behavioral health network providers and facilities around clinical determinations, policy inte ... More
  • Headquarters Office; Rochester Office; Tarrytown Office
    Req #155
    Tuesday, July 2, 2019
    Status: Part-time, Exempt: Yes     Provides clinical expertise and timely first and second level clinical determinations based on MVP’s policies/procedures, state and federal guidelines, national accreditation standards, benefits interpretations, and other medical necessity criteria as necessary.  Conducts pediatric reviews. Lead’s MVP’s efforts to collaborate in person and virtually with behavioral health network providers and facilities around clinical determinations, policy interpr ... More