• LPN-Utilization Mgmt Reviewer - Case Management…

    Guthrie (Cortland, NY)
    …contractual reimbursement requirements and to assist in ensuring generation of clean claims in a timely manner + Securing authorization as appropriate + Documenting ... plans and related UM requirements preferred. Experience with CPT/ICD coding, medical record or chart auditing, and experience in utilization management processes… more
    Guthrie (10/28/25)
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  • Managing Director, Actuarial Services

    Evolent (Albany, NY)
    …and contracting. **What You'll Be Doing:** + Serve as the lead for medical cost and revenue projections for Performance Suite business + Partner with Performance ... and size impact of innovative care models + Oversee Medical Cost Action Planning work to identify, size, and...clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for… more
    Evolent (10/21/25)
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  • Senior Data Engineer

    CVS Health (Albany, NY)
    …The position is open in a data engineering team that is responsible for processing Claims , Revenue, Rx Medicare Specific files and data from 30+ payors ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
    CVS Health (12/14/25)
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  • Sr Admin Assistant

    Rochester Regional Health (Rochester, NY)
    …management in a healthcare environment + Advanced computer skills; word processing , spreadsheets, databases, graphics and internet access + Excellent written and ... organization skills and the ability to work independently + Medical terminology experience preferred + Excellent communication and interpersonal skills… more
    Rochester Regional Health (12/13/25)
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  • Risk Adjustment Coding Specialist -St. Peter's…

    Trinity Health (Albany, NY)
    …& Audit to develop and implement provider documentation improvement plans. Ensures medical documentation and coding compliance with Federal, State and Private payer ... diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing system...services. Using billing system work queues and natural language processing (NLP) tools to support addressing HCC codes for… more
    Trinity Health (12/12/25)
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  • AI Innovation Lead - Data Science Lab

    Guardian Life (New York, NY)
    …AI. + Apply AI/ML to unstructured data sources such as insurance contracts, medical records, sales notes, and customer service logs. + Deliver solutions that enhance ... underwriting risk assessment, claims auto-adjudication, and customer servicing. Operational Excellence + Establish scalable processes, frameworks, and governance… more
    Guardian Life (12/11/25)
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  • Sr Construction Supervisor

    PSEG Long Island (Bethpage, NY)
    …following your date of hire., designed to support your total well-being: medical , dental, vision, paternal leave and family leave programs, behavioral health ... Supervise all phases of construction execution, monitoring, control, and invoice processing through closeout. + Anticipate potential problems during construction and… more
    PSEG Long Island (12/10/25)
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  • Senior Data Scientist, Agentic AI (Insurance…

    Guardian Life (New York, NY)
    …track record of delivering enterprise level AI/ML solutions and products., and natural language processing (NLP). In this role, you will be working in a team led by ... and interpret unstructured data (eg, insurance applications, underwriter's notes, medical records, customer interactions). + Develop autonomous agents, multi-step… more
    Guardian Life (12/05/25)
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  • Coordinator Patient Accounts

    UHS (Binghamton, NY)
    …mechanisms. Demonstrates knowledge and understanding of the process of billing, claims processing and receivable follow-up. Primary Department, Division, or ... Comprehensive Benefits for Life & Family - We offer medical , dental, and vision coverage starting the first of...in Broome and surrounding counties. UHS provides healthcare and medical services for two-thirds of the region's population, produces… more
    UHS (12/04/25)
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  • Human Resources Manager

    Elderwood (Williamsville, NY)
    …Free On-Site Parking, Generous PTO & holiday package, Life Insurance, Medical , Dental, and Vision insurance Responsibilities The Human Resources Manager supports ... certified arrange for training.10. Coordinate new hire physicals and obtain required medical documentation for TST.11. Ensure that all personnel actions are properly… more
    Elderwood (11/20/25)
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