• 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 ... and appeals, document research of initial coverage determinations, and lead coordination of clinical review with appropriate internal stakeholders and… more
    Independent Health (10/07/25)
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  • Manager, Provider Performance

    Centene Corporation (Queens, NY)
    …Bachelor's degree in related field or equivalent experience. 4+ years of managed care , health delivery system and/or project and staff management ... support, discuss performance metrics, and identify opportunities for improvement in patient care and clinical practices + Focuses on value-based care model… more
    Centene Corporation (09/24/25)
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  • Director, Research Finance & Analysis

    Weill Cornell Medical College (New York, NY)
    …analyses for proposed research initiatives and investments as well as managed care contracting negotiations with NewYork-Presbyterian. Present findings to ... comprehensive academic medical center that is committed to excellence in patient care , scientific discovery, and the education of future physicians and scientists in… more
    Weill Cornell Medical College (07/26/25)
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  • Behavioral Health Counselor IV - SPARC

    Trinity Health (Guilderland, NY)
    …and communication skills are required. + Knowledge of working with community agencies and managed care representatives is desired. Pay Range: $23.90 - $32.85 Pay ... Here at SPARC in Guilderland, an affiliate of St. Peter's Health Partners, we care for more people in more places. **Position Highlights:** + **Recognized leader… more
    Trinity Health (07/26/25)
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  • CTTP-Youth Advocate

    House of the Good Shepherd (Utica, NY)
    …summaries in client files to ensure compliance with all Federal, State, Funder, Medicaid Managed Care and Hillside standards. + Participate in agency and team ... youth perspective and sharing their expertise in family-driven, youth-guided care . In addition, this position will lead ...youth-guided care . In addition, this position will lead projects, mentor level I staff, and facilitate Youth… more
    House of the Good Shepherd (09/26/25)
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  • Scheduler

    Catholic Health Services (East Hills, NY)
    …operating rooms through telephone, fax and computer with Physician offices. + Ensures all Managed Care requirements are met at the time of scheduling and ... by US News & World Report as a national leader for Cardiology & Heart Surgery, as well as...in Geriatrics, Neurology & Neurosurgery, Orthopedics, and Pulmonology. Nursing care at St. Francis is also nationally recognized, with… more
    Catholic Health Services (08/13/25)
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  • Medical Director, Commercial Line of Business

    Excellus BlueCross BlueShield (Rochester, NY)
    …experience in medical management, utilization review and case management. + Knowledge of managed care products and strategies. + Demonstrated ability to educate ... not limited to, Medical and Pharmacy Utilization Management, quality management, member care management, and medical policy processes, and support for our various… more
    Excellus BlueCross BlueShield (09/30/25)
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  • Director, Provider Relations

    Centene Corporation (Queens, NY)
    …equivalent experience. 7+ years of provider relations or contracting experience in a managed care or insurance environment, preferably in Medicare or Medicaid. ... department including negotiations and administering organization policies and procedures. + Lead and inspire a high-performing team, fostering a collaborative and… more
    Centene Corporation (09/23/25)
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  • Medical Director, Psychiatry (SafetyNet…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …Level I + New York State licensed physician. + Minimum 7 years of experience in a BH managed care settings or BH clinical setting (at least 2 of which are in a ... goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in...in the community. + Strong verbal presentation skills to lead internal and external discussions at board levels +… more
    Excellus BlueCross BlueShield (08/09/25)
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  • Project Manager V

    Centene Corporation (New York, NY)
    …the performance of staff. Proficient with MS-Office applications. Healthcare and managed care experience preferred. Understanding of Agile methodology is ... including a fresh perspective on workplace flexibility. **Position Purpose:** Fidelis Care is seeking a strategic and detail-oriented Project Manager to join… more
    Centene Corporation (10/08/25)
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