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: 

• Associate degree preferred (or equivalent relevant work experience).
• The availability to work full-time, remote within NYS.
• Medical claims processing analysis skills with strong attention to detail and quality control focus.
• 3+ years of experience in a related field (accumulator data exchanges and/or health insurance claims processing) preferred.
• 3+ years of experience using Microsoft Word and Excel preferred.
• Critical thinking and problem-solving/troubleshooting skills; able to analyze information, multi-task, prioritize, and adapt in a changing environment.
• 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: 

• Partner with Sales/Marketing, Pharmacy, Claims Operations, and other business units to communicate and resolve accumulator issues aligned with organizational strategy and values.
• Investigate and resolve accumulator-related issues tied to medical, pharmacy, and behavioral health claims using Facets and Macess systems while meeting assigned project goals.
• Review, analyze, and evaluate accumulator errors using existing and new data reports; identify root causes and trends, document resolutions, and opportunities for process improvement.
• Respond to member service calls and inquiries regarding accumulator inquiries, coordinate resolution with impacted internal departments and MVP partners.
• Document information in the appropriate location; participate in meetings on accumulator objectives, issues, and progress; help maintain current training and process documentation.
• Run and interpret reports to identify impacted claims, dollar volume, and group/member impact; proactively identify process and efficiency opportunities for accumulator data transmissions.
• Participate in upper management meetings as needed to provide status updates, communicate risks and impacts, and present findings and recommendations clearly and professionally to internal stakeholders and vendors, as needed.
• 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: 

Remote within NYS

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. 

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 hr@mvphealthcare.com.