• Territory Manager Urology General Surgery (Long…

    GE HealthCare (NY)
    …or related setting. Previous healthcare ultrasound sales experience and selling to managed care / hospital organizations preferred. + Ability to energize, ... management skills + Previous healthcare ultrasound sales experience and selling to managed care /hospital organizations preferred. We expect all employees to live… more
    GE HealthCare (07/25/25)
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  • Behavioral Health Advisor

    Staffing Solutions Organization (Albany, NY)
    …have experience and an understanding of Medicaid and Medicaid services, including Managed Care and billing practices **Basic Qualifications:** + Bachelor's ... Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse… more
    Staffing Solutions Organization (07/16/25)
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  • Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    …outlook required. 8 years of experience in multi- hospital system and / or managed care required. 10 years of experience in Federal, state and accreditation ... reimbursement methodologies, coverage issues, documentation, coding conventions and insurance / managed care practices including but not limited to: utilization… more
    Kaleida Health (06/19/25)
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  • Oncology Sales Specialist - Upstate NY - Johnson…

    J&J Family of Companies (Albany, NY)
    …long-term sales potential relevant to percentage of patients treated, patient mix, Managed Care organizations and Specialty Pharmacies, and new protocols or ... + Experience in hospital and large account sales, understand complex reimbursement and managed care dynamics with a documented history of successful sales… more
    J&J Family of Companies (08/29/25)
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  • Manager, Medical Economics (Medicaid) - REMOTE

    Molina Healthcare (Syracuse, NY)
    …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
    Molina Healthcare (08/27/25)
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  • Senior Specialist, Delegation Oversight (Remote)

    Molina Healthcare (Yonkers, NY)
    …or equivalent combination of education and experience. **Required Experience** + 3+ years managed care experience. + Min. 1 year experience completing delegation ... Care related field. **Preferred Experience** + 5 years managed care experience. + 2 years' experience completing delegation oversight assessments/audits. +… more
    Molina Healthcare (08/21/25)
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  • Clinical Counselor Outpatient Services

    Educational Alliance, Inc. (New York, NY)
    …clinical charts, engaging in pre-audits of charts to ensure compliance with OASAS, managed care , and CARF standards. + Send weekly, monthly, and quarterly ... charts, engaging in pre-audits of charts to ensure compliance with OASAS, managed care , and CARF standards. + Send weekly, monthly, and quarterly reports to… more
    Educational Alliance, Inc. (08/20/25)
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  • Formulary and Medical Strategies Senior…

    Humana (Albany, NY)
    …for the Medicaid line of business. + Utilizes broad understanding of pharmacy, managed care , PBM, market and regulatory insights to support the implementation ... Qualifications: + Bachelor's degree or equivalent + 3+ years of experience in managed care or other pharmacy related field + 3+ years of experience of leading… more
    Humana (08/20/25)
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  • Medicaid State Technology Lead

    Humana (Albany, NY)
    …policy administration or related field;work experience may meet this need + 5 + years managed care experience + 5 + years in Medicaid program implementation or ... and clinical operations; Medicaid preferred + Comprehensive understanding of a Medicaid Managed Care architecture, tools, utilities and processes utilized to… more
    Humana (08/19/25)
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  • Prior Authorization Coordinator

    SUNY Upstate Medical University (Syracuse, NY)
    …established criteria. Obtain prior authorization from intermediaries and payers, including managed care companies, insurance companies, and review organizations. ... Experience with healthcare insurance prior authorization/coding and performing insurance carrier/ managed care review preferred. National Pharmacy Technician… more
    SUNY Upstate Medical University (08/08/25)
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