• Medical Director - IP Claims Management

    Humana (Albany, NY)
    …this knowledge in their daily work. The Medical Director's work includes computer- based review of moderately complex to complex clinical scenarios, review ... may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes,… more
    Humana (12/11/25)
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  • Data Manager

    Humana (Albany, NY)
    …Medicaid operations IT, the data warehouse team, and users of data (Finance, Clinical , Actuarial, DH&A analyst and report end users). + Development of analytic and ... enterprise teams to include Medicaid Governance, the Center of Clinical Effectiveness Services & Products, as well as external...tables, charts, V-Lookups and graphs. + Working knowledge with coding in SQL and data extraction and (BI) analysis… more
    Humana (12/24/25)
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  • Medical Director-Payment Integrity

    Humana (Albany, NY)
    …this knowledge in their daily work. The Medical Director's work includes computer- based review of moderately complex to complex clinical scenarios, review ... discussions with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes,… more
    Humana (12/11/25)
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  • Data Analyst I

    University of Rochester (Rochester, NY)
    …York State Department of Health (NY DOH) and the National Trauma Data Bank (NTDB) based on the NY DOH and NTDB standards. Will serve as trauma registry expert for ... + Accurately identify all trauma admissions, transfers, and deaths, using clinical identifiers and strict inclusion/exclusion criteria. + Complete and verify for… more
    University of Rochester (10/28/25)
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  • Medical Director, Commercial Line of Business

    Excellus BlueCross BlueShield (Rochester, NY)
    …+ Provides clinical expertise on ARD cases, Quality of Care cases, clinical editing, coding reviews and inquiries. + Makes accurate and consistent ... current and working knowledge of Utilization Management Standards. + Clinical skills are excellent and evidence- based medicine...including fluorescent lighting. + Ability to work in a home office for continuous periods of time for business… more
    Excellus BlueCross BlueShield (12/29/25)
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  • Medical Billing / Rev Cycle Analyst - Ortho Team…

    Trinity Health (Albany, NY)
    …Avenue, Albany, NY. Searching for a motivated medical biller for our orthopedics team. Coding a plus but not needed. Insurance knowledge a must. Position reports to ... 5 days a week and 1 allowed work for home day a week. **Position Highlights:** + Quality of...of a medical practice. Medical billing/insurance background a must. Coding not required but a plus. **Responsibilities:** + Responsible… more
    Trinity Health (12/06/25)
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  • Cytotechnologist

    University of Rochester (Rochester, NY)
    …and interpretations of gynecologic specimens including retrieval of all significant clinical history, referral of all abnormal smears to pathologist for consulting ... diagnosis, one on one interpretation of abnormal with the pathologist and recording, coding and reporting of diagnosis and filing patient smears. Rescreens 10% of… more
    University of Rochester (12/11/25)
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  • Senior Physician, Patient Safety (Senior Drug…

    Parexel (Albany, NY)
    …leverage your medical expertise to ensure the safety of patients in clinical trials and post-marketing settings. In this pivotal role, you'll perform comprehensive ... to (including complex and challenging cases requiring expert judgement)), clinical trial, and literature cases including combination products {drug-device})… more
    Parexel (12/06/25)
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  • HIM Technician - TSH

    Albany Medical Center (Albany, NY)
    …Duties and Responsibilities + Assist the HIM Operations Manager to ensure all clinical documentation is available to coding /billing and clinical staff ... position focuses on the retrieval, preparation, scanning and indexing of clinical documentation for AMHS' inpatient and outpatient facilities. The HIM Technician… more
    Albany Medical Center (12/03/25)
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  • Registered Nurse Consultant (Nationwide)

    Vatica Health (Rochester, NY)
    …role is considered hybrid, you will have the opportunity to work remotely from home and have expectations to go onsite to practices locally. The distance to commute ... multiple sources and consolidate into one comprehensive and detailed view. Use clinical judgement and data to reconcile conflicting information from various sources.… more
    Vatica Health (12/21/25)
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