• Lead Experience Researcher

    Humana (Albany, NY)
    …health services research or health economics and outcomes research (HEOR) within a managed care or healthcare research organization + Experience in health equity ... a part of our caring community and help us put health first** The Lead Experience Researcher drives special projects to uncover the root cause of patient and… more
    Humana (10/08/25)
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  • Program Director, Quality Incentives

    Molina Healthcare (Rochester, NY)
    …Business, Health Administration or related field. **PREFERRED EXPERIENCE:** 10+ years managed care experience specifically within Risk Adjustment and/or Quality ... in lieu of Bachelor's Degree). **REQUIRED EXPERIENCE:** * 7+ years managed healthcare experience with proven relationship management responsibilities * Proven… more
    Molina Healthcare (09/10/25)
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  • Insurance Strategy Lead

    Humana (Albany, NY)
    …MPH, or other relevant advanced degree + Healthcare industry experience, particularly in managed care or provider sectors + Experience leading strategy projects ... and other health plans to millions. By integrating insurance with care delivery through CenterWell, Humana is improving healthcare access, coordination, and… more
    Humana (09/17/25)
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  • Utilization Management Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …and working knowledge of Utilization Management Standards. + Experience in interpreting managed care benefit plans and strong knowledge of government program ... various levels of care and/or services. + Participate in committees and lead when required Level III (in addition to Level II Accountabilities) + Displays… more
    Excellus BlueCross BlueShield (10/07/25)
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  • Data Science Analyst III - Mount Sinai Health…

    Mount Sinai Health System (New York, NY)
    …+ Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or ... others in the Data Science team and takes the lead role in project initiatives. **Qualifications** + BA or...higher preferred, in analytics development expertise, preferably in health care , or for a health provider, health plan or… more
    Mount Sinai Health System (10/08/25)
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  • Per Diem - Behavioral Health Counselor III- St.…

    Trinity Health (Troy, NY)
    …skills are required as well as knowledge of working with community agencies and managed care representatives is desired. + Experience working with a diverse ... and an affiliate of St. Peter's Health Partners, we care for more people in more places. **Position Highlights:**...and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes… more
    Trinity Health (10/08/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …, end-of-life- care and hospice. + Apply knowledge of Health Insurance and Managed Care Programs, along with values- based care , pay-for-performance ... PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level of … more
    Mohawk Valley Health System (10/07/25)
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  • Case Manager, RN (Commercial)

    Excellus BlueCross BlueShield (Rochester, NY)
    …Must demonstrate proficiency with the Microsoft Office Suite. + Experience in interpreting managed care benefit plans and strong knowledge of government program ... program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and… more
    Excellus BlueCross BlueShield (09/30/25)
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  • Sr Analyst, Performance Suite Analytics

    Evolent (Albany, NY)
    …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
    Evolent (09/22/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Latham, NY)
    …experience. + Certification as a Case Manager. + Minimum 2 years' experience in acute care setting. + Managed Care experience. + Ability to talk and ... The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (09/11/25)
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