• Addictions Program Specialist 2

    New York State Civil Service (New York, NY)
    …billing patterns and troubleshooting reimbursement practices that are inconsistent with model managed care contract . * Supervise staff, including time ... limited to the following:* Provide direct management and oversight of the Medicaid Managed Care Behavioral Health plan audits, including desk reviews, written… more
    New York State Civil Service (09/25/25)
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  • Medical Specialist II-Ophthalmology-Albany,…

    Regeneron Pharmaceuticals (New York, NY)
    …history of high sales performance + Experience with reimbursement programs, government programs, managed care , formulary and contract negotiation To be ... **Medical Specialist , Diabetic Eye - Albany, Syracuse & White...day might include the following:** The Diabetic Eye Medical Specialist will report to the Regional Director and will… more
    Regeneron Pharmaceuticals (09/20/25)
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  • Utilization Review Specialist

    Amergis (Albany, NY)
    …the ability tolearn new information systems and software programs + General knowledge of managed care delivery system + Current CPR if applicable + TB ... Salary: $52 / Hour The Utilization Review Specialist is responsible for theassessment and review of...system with a concentration ontasks that promote cost-effective quality care and cost containment inaccordance with various federal and/or… more
    Amergis (10/10/25)
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  • Healthcare Specialist

    WM (Buffalo, NY)
    …a safe, responsible, and sustainable way. **Position Purpose:** The Healthcare Specialist is responsible for providing strategic guidance towards the compliant, safe ... of the regulations associated with the waste streams being managed (ie, EPA, DOT, DEA, and any other state...customized training for the implementation and maintenance of the contract + Regularly schedule and complete customer-facing activity with… more
    WM (08/21/25)
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  • Senior Specialist , Government Contracts…

    Molina Healthcare (Syracuse, NY)
    …diploma or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and ... Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.… more
    Molina Healthcare (09/27/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Buffalo, NY)
    …**X** **PE** **R** **I** **E** **N** **C** **E:** + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health ... Responsible for meeting production standards set by the department. + Apply contract language, benefits, and review of covered services + Responsible for contacting… more
    Molina Healthcare (10/10/25)
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  • Provider Contracts Manager HP - Core

    Molina Healthcare (Syracuse, NY)
    …ensure effective and efficient business results. * Trains and monitors newly hired Contract Specialist (s). * Participates with the management team and other ... field including, but not limited to, provider's office, managed care , or other health care...multispecialty provider groups. * 3+ years experience in provider contract negotiations in a managed healthcare setting… more
    Molina Healthcare (09/25/25)
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  • Specialty Sales Representative, Immunology

    Grifols Shared Services North America, Inc (Albany, NY)
    contract strategy, and represent needs of the customer. *Remain cognizant of managed care coverage throughout the business territory including major accounts ... approach to respond to business customers. The SSR will liaise with Marketing, Managed Markets, Operations, CL&D, Medical Affairs and Telesales to achieve the goals… more
    Grifols Shared Services North America, Inc (10/10/25)
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  • Business Officer 2

    New York State Civil Service (Tupper Lake, NY)
    …Officer Trainee 1, or Business Officer Trainee 2; Or B. Administrative Specialist 1, Assistant Office Services Manager, Contract Management Specialist ... financial transactions are authorized and appropriate.* Act as Contract Management Liaison* Other Duties as assigned.#LI-AK1#LI-NB1LinkedIn: https://www.linkedin.com/company/nys-office-for-people-with-developmental-disabilities/posts/?feedView=all… more
    New York State Civil Service (10/10/25)
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  • Clinical Reviewer

    Independent Health (Buffalo, NY)
    …required. Utilization Management experience preferred. + Comprehensive knowledge and experience with managed care benefit plans. + Ability to research and assist ... accordance with regulatory standards, clinical criteria, and member benefit contract . **Qualifications** + Registered Nurse (RN) with active, current, unrestricted… more
    Independent Health (10/07/25)
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