• Utilization Management Reviewer, Licensed…

    Excellus BlueCross BlueShield (Rochester, NY)
    …and post- service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members' behavioral health ... + Acts as a resource and liaison to the provider community in conjunction with Provider Relations,...assignments; cross-trained to review various levels of care and/or services . + Participate in committees and lead more
    Excellus BlueCross BlueShield (11/19/25)
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  • Licensed Master Social Worker

    New York State Civil Service (NY)
    …Office (SPSRFO). Divisions within the Regional Field Office include the following: Service Access (Front Door and Waiver Services ), Eligibility, Self-Direction, ... team members under the supervision of the front door lead .* Provide individuals/families with information/education on OPWDD...referral service that connects employees with local service providers and support services to address… more
    New York State Civil Service (11/24/25)
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  • SVP, Oncology

    Evolent (Albany, NY)
    …excellence, product innovation, clinical partnerships, and financial impact assessment + Lead provider and member engagement strategies to improve the ... on medical oncology, radiation oncology, and surgical oncology + Provide leadership to overall oncology service line...quality of care for oncology care services + Lead the development of new… more
    Evolent (09/28/25)
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  • CTI Care Manager

    Monroe Plan for Medical Care (Olean, NY)
    …state, and local pay equity laws. POSITION SUMMARY The Care Manager will provide Critical Time Intervention (CTI) services to identified and enrolled members. ... traditional case management - working hands-on to coordinate care, advocate for essential services , and help restore stability and dignity to those most at risk. If… more
    Monroe Plan for Medical Care (10/25/25)
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  • Project Coordinator

    New York State Civil Service (Albany, NY)
    …will be responsible for, but not limited to, the following core responsibilities: Lead project oversight and coordination for the Medicaid Independent Assessor ... briefings on IA contract progress, challenges, and outcomes to executive leadership; Provide project oversight and support for additional initiatives such as the… more
    New York State Civil Service (11/19/25)
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  • Chief Medical Officer - Managed Long-Term Care…

    CVS Health (Albany, NY)
    …The CMO provides strategic leadership to ensure that long-term care services are delivered in a person-centered, cost-effective, and clinically sound manner, ... of Health (NYSDOH) regulations. **Key Responsibilities:** Clinical Oversight + Lead development and implementation of clinical protocols and care standards… more
    CVS Health (10/29/25)
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  • Family Peer Advocate I or II - Orleans & Genesee…

    Hillside Family of Agencies (Batavia, NY)
    …including evenings, as determined by family needs that arise outside of regular service hours. Essential Job functions + Provide informational and educational ... the foundation of any thriving community. Guided by this belief, we provide community-based services , education, and residential treatment to positively impact… more
    Hillside Family of Agencies (11/17/25)
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  • Senior Clinical Programs Pharmacist

    Humana (Albany, NY)
    …business processes, systems, tools, regulations and structure and how they interrelate to provide products and services that create value for Humana members + ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
    Humana (10/18/25)
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  • Developmental Disabilities Operations Director 1

    New York State Civil Service (NY)
    …will participate and lead multiple committees, present at various in- service training venues including regularly scheduled statewide provider trainings, ... deliver both in-person and virtual training for new staff, provide support and oversight between field office staff and...referral service that connects employees with local service providers and support services to address… more
    New York State Civil Service (11/19/25)
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  • Principal, Stars Enterprise Activation - Insurance…

    Humana (Albany, NY)
    …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ ... sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
    Humana (11/19/25)
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