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  • Headquarters Office
    Req #129
    Wednesday, June 19, 2019
    Status: Full-time, Exempt: Yes           Summary: Manages the initial implementation, administration, and vendor relationships. Interacts with delegated vendors and MVP staff to resolve issues in a timely manner. Assists with other provider recruitment and contracting efforts as needed. Administers the vendor performance program for the Delegated Vendor Management Department and periodically audits compliance of internal MVP departments. Performs other ... More
  • Headquarters Office; Rochester Office
    Req #128
    Wednesday, June 19, 2019
    Status: Full-time, Non-Exempt           Summary: Monitors and records the quality of work performed by units within the Operations Department for pre-payment of claims and claims audits, for all regions in all lines of business. Identify trends in specific errors and error rates. Determines and recommends needs for retraining, or clarification of work procedures. Develops and produces, periodic reports based on audits/projects completed, for the Quality Control L ... More
  • Headquarters Office; Rochester Office; Tarrytown Office; Virtual
    Req #127
    Wednesday, June 19, 2019
       Status: Full-time, Exempt: Yes     Summary: In collaboration with the Chief Medical Officer and other stakeholders, responsible for developing and implementing strategies for: Enterprise-wide quality management leadership and integration o   Strategic leadership to move company culture towards enterprise-wide accountability and alignment around quality improvement o   Tactical leadership for enterprise quality team includ ... More
  • Headquarters Office; Rochester Office; Tarrytown Office; Virtual
    Req #126
    Wednesday, June 19, 2019
        Status: Full-time, Exempt: Yes Summary: In collaboration with the Chief Medical Officer and other stakeholders, responsible for developing and implementing health management strategies for: Care Management Programs Utilization Management Programs Integrated health model development (physical and behavioral health) Clinical integrati ... More
  • Rochester, NY, US; Schenectady, NY, US
    Req #125
    Monday, June 17, 2019
     Be a part of the transformation at MVP Healthcare. As a service-optimized IT organization we are focused on delivering business value to our customers and are continually evolving the way MVP uses technology to grow our business. The IT Governance Analyst has an essential role in the journey to a service-optimized IT organization.  Our IT Risk Management Analyst will primarily support IT Audit, Compliance and Risk Management activities required to enable our organization to reach its goals. As ... More
  • Rochester, NY, US; Schenectady, NY, US
    Req #124
    Monday, June 17, 2019
      Summary: Be a part of the transformation at MVP Health Care. Information Technology & Transformation Services (IT & TS), as a service-optimized IT organization, is focused on delivering business value to our customers and are continually evolving the way MVP uses technology to grow our business. The role has an essential role in our transformation to a service-optimized IT organization.    This position will support Department goals of implementing modern platforms for the enterprise while ... More
  • Rochester, NY, US; Schenectady, NY, US
    Req #123
    Monday, June 17, 2019
    Be a part of the transformation at MVP Healthcare. As a service-optimized IT organization we are focused on delivering business value to our customers and are continually evolving the way MVP uses technology to grow our business. The IT Governance Lead has an essential role in the transformation to a service-optimized IT organization. Our IT Governance Lead will support the effective and efficient use of IT in enabling our organization to reach its goals. The person in this role will help to des ... More
  • Tarrytown, NY, US
    Req #118
    Monday, June 17, 2019
          Summary: The Enrollment and Retention Call Center Representative must provide fair and impartial information to individual Marketplace customers regarding coverage options available through the Exchanges. They help facilitate renewal and enrollment in Qualified Health Plans (QHPs), insurance affordability programs, Medicaid, the Essential Plan, and Child Health Plus as permitted under federal and state guidance. Majority of contact is via telephone, wit ... More
  • Schenectady, NY, US
    Req #74
    Monday, June 17, 2019
     Summary:This position will be primarily responsible for performing independent and objective auditing and monitoring of the Company to ensure compliance with all applicable laws, regulations and policies/procedures. Independent auditing and monitoring includes: conducting audits and monitoring, analyzing results, recommending corrective actions, creating reports, educating and following up with the business areas to ensure the implementation of corrective actions. This position holds primary re ... More
  • Tarrytown Office
    Req #116
    Monday, June 17, 2019
    Associate, Chart Procurement Specialist  Status: Full-time, Exempt: No       Summary: This position works with provider offices to obtain medical records for the purpose of the Risk Adjustment team validating diagnoses that were sent to CMS (Center for Medicare & Medicaid Services). Works to collect medical records under a sometimes very strict deadline. Contacts local provider offices to schedule appointments to obtain medical records using a laptop and mobil ... More
  • Schenectady, NY, US
    Req #114
    Monday, June 17, 2019
    Status: Full-time, Exempt           Summary: The role will be responsible for driving the successful activation and adoption of Dynamics365 CRM throughout the enterprise – this will be achieved by acting as the hero/ambassador/champion/coach for MVP departments and stakeholders; executing on-point and pertinent training, coaching and advocacy by ultimately immersing yourself into the end-user’s world.  With a direct focus on usage, adoption and evolvi ... More
  • Schenectady, NY, US
    Req #113
    Monday, June 17, 2019
    Status: Full-time, Exempt           Summary: We are looking for an experienced CRM professional to play a critical role in planning, researching and road mapping the next generation of MVP’s customer relationship management portfolio of projects.  The individual we’re seeking should be an exceptional critical thinker with a passion for storytelling and the ability to author business cases, grounded in research and market intelligence, that demonstrate ... More
  • Schenectady, NY, US
    Req #111
    Monday, June 17, 2019
    Professional, CRM Technical Writer       Status: Full-time, Exempt: Yes     Summary: MVP Health Care is seeking a Technical Writer to join our Marketing & Communications team. This cross-functional position will team up with our CRM Customer Success and Adoption Professionals to lead the charge for training, end user, internal, and development documentation for our newly created CRM practice. Your experience writing technical documentation and guideline ... More
  • Tarrytown Office
    Req #110
    Friday, June 14, 2019
    Summary: This position will work with all stakeholders to ensure that all of the child’s healthcare needs are met.  Through a collaborate internal process, this position will review all Plans of Care, CANS  assessments, and recommendation for services, including approval or denial of services as appropriate.  The role will oversee the authorizations of person centered, individualized andHome and Community Based Services; maintaining children at home with support and services in the least r ... More
  • Rochester, NY, US
    Req #108
    Friday, June 14, 2019
    Status: Part Time (20 hours per week) Location: Rochester, NY   Commercial Health Promotion Intern -   Rochester MVP’s Commercial Health Promotion Team assists employer groups to develop worksite well-being programs. The program intern would help support a number projects to assist employees and their families to develop and maintain optimum well-being. In addition the intern will support development and implementation of well-being programs offered in ... More
  • Tarrytown, NY, US
    Req #106
    Friday, June 14, 2019
    Status: Summer Intern Location: Tarrytown, NY        The intern will be responsible for assisting the Medicaid Strategic Business Unit with day-to-day activities to ensure organizational compliance with all Medicaid and Child Health Plus contract requirements and State, Federal and local rules and regulations. Provide departmental support to ensure SBU programs and projects meet organization goals and requirements Responsibilities include document managem ... More
  • Utica Office
    Req #105
    Friday, June 14, 2019
    Leader, Provider/Community Based Outreach Operations         Responsible for outreach and promotion of MVP lines of business to individuals and community groups in target populations. Supervise a team of individual products representatives and outreachrepresentatives. Ensure that the team’s productivity meets projected targets and monthly goals. Work closely with staff of the Department of Social Services and affiliated Health Centers. Assist the Leader III, Field Manager in impl ... More
  • Headquarters Office
    Req #104
    Thursday, June 13, 2019
    Status: Full-time, Exempt   Summary: To assist in supervising of Credentialing Staff members (Assts, Outreach Coordinator and IH Credentialing Specialists) in overseeing the day-to-day functions of the Credentialing Department in order to ensure compliance with MVP Policies, NCQA and other regulatory guidelines.  Supervises the assigned staff members to ensure the production of credentialing and recredentialing files are completed in full regulatory compliance.  Assi ... More
  • Headquarters Office
    Req #103
    Thursday, June 13, 2019
    Summary: To review, manage, and facilitate general quality overview and improvements in all areas of the Credentialing and to act as support in training, employee development, and process improvements. Manages and facilitates the Credentialing Quality Control program for all types of Credentialing and Recredentialing files. Includes coordinating quality control functions with other quality control staff to assure consistency in reviews. Provides feedback, and when applicable, additional tr ... More
  • Headquarters Office
    Req #102
    Thursday, June 13, 2019
    Summary: Conducts verification of and processes credentialing and recredentialing applications of providers and organizational facilities in accordance with MVP Policies, NCQA standards, CMS, NYS Department of Health and other regulatory agencies. Processes Credentialing and Recredentialing Applications for practitioners and organizational providers including preparing files for the MVP Credentials Committee. Conducts primary source verifications from various sources (hospitals ... More
  • Rochester, NY, US; Schenectady, NY, US
    Req #88
    Thursday, June 13, 2019
     Summary:As a member of a Scrum team, the Senior Software Engineer has primary responsibility for planning, design, and developing applications for MVP.   The engineer works with business and technology partners to deliver software solutions to support the business.  The engineer also serves as a role model and technical lead on the Scrum teams to promote quality, innovative, and scalable solution delivery.The role includes but is not limited to the following: ·         Must be able to develop q ... More
  • Schenectady, NY, US
    Req #100
    Thursday, June 13, 2019
     As a member of a Scrum team, the Senior Quality Engineer is primarily responsible for ensuring that quality products are delivered to the organization. The candidate will work with a cross-functional team to understand business requirements and break them into user stories, develop test plans, test cases and execute test scenarios to ensure we are delivering high quality code.  The ideal candidate is a highly motivated, self-starter who is passionate about quality assurance and can work effecti ... More
  • Headquarters Office; Rochester Office
    Req #99
    Wednesday, June 12, 2019
    Professional, Case Manager    Status: Full-time, Exempt: Yes   Summary: This position will utilize the essentials of an integrated case management model that includes assessment, planning, implementation, care coordination, monitoring and advocacy to meet the member’s overall comprehensive health needs. Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of designated members, act as a proactive partner, and ... More
  • Rochester Office; Tarrytown Office
    Req #98
    Wednesday, June 12, 2019
    Professional, Transition Case Manager - BH     Status: Full-time, Exempt: Yes         Summary: This role will provide support to MVP members who are at risk for behavioral health or substance use readmission. MVP’s Transition Care team will outreach members during hospitalizations/rehabilitation and post discharge, to assist them in overcoming major “barriers to care”. This coaching is done through a variety of methods such as home visits and tel ... More
  • Headquarters Office; Rochester Office
    Req #97
    Wednesday, June 12, 2019
    Professional, Clinical Pharmacist    Status: Full-time, Exempt: Yes   Summary: This individual will perform and be cross-trained in selected departmental job functions as assigned. These include, but are not limited to: Performing prospective and/or retrospective coverage determinations in accordance with MVP pharmacy and/or medical policy coverage criteria and state and/or federal regulations, with appropriate notification to physician, member, and ven ... More