• Utilization Management Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …I Accountabilities) + Offers process improvement suggestions and participates in the solutions of more complex issues/activities. + Mentors staff and assists with ... of care and/or services. + Participate in committees and lead when required Level III (in addition to Level...and strong knowledge of government program contracts (Medicare and Medicaid ) and benefits, preferred. + Strong written and verbal… more
    Excellus BlueCross BlueShield (10/07/25)
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  • Program Director (Provider Data Mgmt)

    Molina Healthcare (NY)
    **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new implementations and ... driving successful launches of new processes, systems, and operational models across Medicaid , Medicare, and Marketplace lines of business. We are seeking a leader… more
    Molina Healthcare (09/04/25)
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  • Coordinator, Individualized Care

    Cardinal Health (Albany, NY)
    …in pharma, payer and hub services allows us to deliver best-in-class solutions -driving brand and patient markers of success. We're continuously integrating advanced ... in a timely manner + Have the ability to lead the team by assisting with answering questions from...with a sense of urgency + Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies,… more
    Cardinal Health (10/24/25)
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  • Long-term Growth Strategy Advisor (Distribution)

    Humana (Albany, NY)
    …strategic planning efforts. The role requires comfort with ambiguity and creating new solutions in the "white space" where answers are not clear cut or readily ... of opportunity through independent analysis and presents actionable findings + Lead key portions of presentations at high-visibility meetings + Oversees conversion… more
    Humana (10/25/25)
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