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  • Headquarters Office; Rochester Office
    Req #133
    Friday, June 28, 2019
       Status: Full-time, Exempt: No Summary: This position will help licensed pharmacists take care of many of the daily operations of the pharmacy department. Including, but not limited: Calling Providers, members, and pharmacies. Providing drug-related information to Customer Care Center and other internal departments. Managing incoming faxes requesting drug coverage; Determining eligibility and pre-authorization necessity, obtaining additional information and initi ... More
  • Headquarters Office; Tarrytown Office
    Req #142
    Friday, June 28, 2019
    SUMMARY:The Program Manager, Medicaid Operations, will accomplish strategicobjectives by leading multiple projects and initiatives for MVP’s governmentprograms. The Program Manager is responsible for monitoring program changes inaccordance with State regulatory guidelines by analyzing new and existingcontract requirements for downstream organizational implications. Develops anddisseminates periodic communications to ensure organizational partners areinformed of Medicaid program requirements and ... More
  • Schenectady, NY, US
    Req #138
    Thursday, June 27, 2019
    Professional, Microsoft Compute Engineer Be a part of the transformation at MVP Healthcare. MVP Healthcare is a nationally-recognized, regional not-for-profit health plan. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,600 employees.  We are continually evolving the way MVP uses technology to grow our business, transforming the organization through Cloud Computing, Agile Delivery, and DevOps. MVP Informat ... 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
  • 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
  • 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
  • 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 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
    Req #77
    Wednesday, June 12, 2019
    Professional, Operations Program Manager    Status: Full-time, Exempt       Summary: The Operations Program Manager will accomplish strategic objectives by leading multiple projects and initiatives. Responsibility for projects includes the direction, coordination, implementation, execution, controls and completion of project, while remaining aligned with strategy, commitments and goals of the organization. The Operations Program Manager has o ... More
  • Headquarters Office; Rochester Office; Tarrytown Office
    Req #75
    Wednesday, June 12, 2019
           Summary: This role will be responsible for ensuring great member and provider experience by accurately and efficiently processing claims adjustments, while concentrating on putting our customers at the center of how Operations operates. Ensures accurate and timely processing of claim adjustments/service forms and ad-hoc projects/retro database items in accordance with medical and ancillary guidelines and benefits. Acts as a liaison with other department and outsid ... More
  • Schenectady, NY, US
    Req #72
    Wednesday, June 12, 2019
    Professional, Medicaid Operations - Implementation      Status: Full-time, Exempt: Yes Referral Bonus: Standard Talent Acquisition Representative: Rosemary Troncoso, rtroncoso@mvphealthcare.com   Summary: The role will accomplish strategic objectives by leading multiple projects and initiatives for MVP’s government programs. Responsibility for projects includes the direction, coordination, implementation, execution, controls an ... More