Top 1639 Sr program representative Jobs in New York, Ny

Representative, Health Plan Provider Relations - Remote Must reside in NY
Molina Healthcare —New York, NY
- $19.84 - $46.42 an hour
- Full-time
- Remote
- Medical office experience
- Mid-level
- Travel
- Health insurance
Data Entry Clerk_Grant Funded Role: Be Into Health Over 50
WILLIAM F RYAN COMMUNITY HEALTH CEN —New York, NY
- $26.93 - $28.49 an hour
- Full-time
- Microsoft Outlook
- Hospital
- Customer service
Quick Apply
10d
Strategic Initiatives Manager, Office of the Deputy Commissioner
Agency DEPT OF HEALTH/MENTAL HYGIENE —Manhattan, NY
- $109,565 - $126,000 a year
- Full-time
- Doctoral degree
- Office
- 1 year
- Wellness program
- Health insurance
Faith Liaison
OFFICE OF THE MAYOR —Manhattan, NY
- $90,000 - $110,000 a year
- Full-time
- Mid-level
- Office
- Administrative experience
- Loan forgiveness
Program Associate
Claims Conference —New York, NY
- $66,000 - $73,000 a year
- Hybrid work
- Home Health
- Communication skills
- Entry level
Quick Apply
Continuing Education Non-Credit Instructor, Humanities & Liberal Arts
Fashion Institute of Technology —New York, NY
- $67.50 - $140.00 an hour
- Part-time
- Hybrid work
- Classroom
- Google Workspace
- 5 years
Sr Specialty Representative - Respiratory - Rochester, NY
Amgen —New York, NY
- $118,091 - $159,771 a year
- 3 years
- High school diploma or GED
- Business Administration
- Disability insurance
- Health insurance
Senior Program Assistant, Bureau of Health Promotion for Justice-Impacted Populations
Agency DEPT OF HEALTH/MENTAL HYGIENE —Queens, NY
- $87,743 - $100,904 a year
- Weekends as needed
- Bilingual
- Microsoft Word
- Microsoft Excel
- Wellness program
- Health insurance
Associate Director, UN Advocacy
International Rescue Committee —New York, NY
- $105,000 - $115,000 a year
- Full-time
- Hybrid work
- 6 years
- Writing skills
- Office
- 403(b) matching
- Disability insurance
Deputy Chief Program Officer
Safe Horizon, Inc. —New York, NY
- $120,000 - $150,000 a year
- Hybrid work
- Computer literacy
- Licensed Clinical Social Worker
- 8 years
- Commuter assistance
- Paid holidays
Quick Apply
Program Master Scheduler
Haas Media LLC —New York, NY
- $93 an hour
- Full-time
- Microsoft Excel
- Bachelor of Science
- 11+ years
Quick Apply
9d
Account Representative
Market Performance Group —Holmdel, NJ
- $50,000 - $85,000 a year
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- Office
- Paid parental leave
- Paid holidays
Quick Apply
Operations Data Analyst, Division Management & Systems Coordination
Agency DEPT OF HEALTH/MENTAL HYGIENE —Queens, NY
- $87,743 - $100,904 a year
- Full-time
- Doctoral degree
- Mid-level
- Office
- Wellness program
- Health insurance
Assistant Project Manager
New Line Structures & Development LLC —New York, NY
- $90,000 - $130,000 a year
- Full-time
- Customer service
- Residential
- Contracts
Quick Apply
Community Center Program Manager
DEPT OF YOUTH & COMM DEV SRVS —Manhattan, NY
- $62,868 - $97,593 a year
- Weekends as needed
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
MEDICAID ELIGIBILITY VERIFICATION SPECIALIST
HRA/DEPT OF SOCIAL SERVICES —Manhattan, NY
- $61,656 - $70,904 a year
- Full-time
- High school
- Data analysis skills
- Mid-level
- Loan forgiveness
- Food provided
Program Analyst
DEPT OF YOUTH & COMM DEV SRVS —New York, NY
- $62,868 - $97,593 a year
- Full-time
- Mid-level
- Office
- High school diploma or GED
- Loan forgiveness
Program Director
OFFICE OF THE MAYOR —Manhattan, NY
- $125,000 - $132,000 a year
- Full-time
- Bilingual
- Management
- Office
- Loan forgiveness
Senior Program Manager, International Sales Enablement
Rippling —New York, NY
- $108,000 - $180,000 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Analysis skills
Chief of Staff
New York University —New York, NY
- $125,000 - $165,000 a year
- Full-time
- 7 years
- Writing skills
- Research

I want to receive the latest job alert for sr program representative in new york, ny

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

sr program representative jobs near new york, ny

Representative, Health Plan Provider Relations - Remote Must reside in NY

Molina Healthcare -
New York, NY

Apply Now

Job Details

Full-time
$19.84 - $46.42 an hour

Benefits

Health insurance

Qualifications

Customer communication
Managed care
Managed care organization experience
Medical office experience
Schedule management
Health insurance knowledge
Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.

Essential Job Duties

Successfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.
Serves as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.
Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.
Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).
Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).
May provide training and support to new and existing provider relations team members as appropriate.

will require to travel at least once a week subject to change.

Required Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
General understanding of the health care delivery system, including government-sponsored health plans.
Organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.
Experience delivering training and facilitating educational presentations.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $19.84 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

sr program representative jobs in new york, ny

Representative, Health Plan Provider Relations - Remote Must reside in NY

Data Entry Clerk_Grant Funded Role: Be Into Health Over 50

Strategic Initiatives Manager, Office of the Deputy Commissioner

Faith Liaison

Program Associate

Continuing Education Non-Credit Instructor, Humanities & Liberal Arts

Sr Specialty Representative - Respiratory - Rochester, NY

Senior Program Assistant, Bureau of Health Promotion for Justice-Impacted Populations

Associate Director, UN Advocacy

Deputy Chief Program Officer

Program Master Scheduler

Account Representative

Operations Data Analyst, Division Management & Systems Coordination

Assistant Project Manager

Community Center Program Manager

MEDICAID ELIGIBILITY VERIFICATION SPECIALIST

Program Analyst

Program Director

Senior Program Manager, International Sales Enablement

Chief of Staff

I want to receive the latest job alert for sr program representative in new york, ny

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected