Univera Healthcare

Job Description: Summary:This position provides support and often leads initiatives related to the Divisional Strategy and Operations. The incumbent leads various projects and workstreams to ensure effective division performance and consultation on opportunities to improve overall div

Job Description: Summary:This position provides support and often leads initiatives related to the Divisional Strategy and Operations. The incumbent leads various projects and workstreams to ensure effective division performance and consultation on opportunities to improve overall div

Job Description: Summary:The Manager Applications Development is responsible for overseeing and evaluating the work of IT staff in both the development of new applications as well as updates fixes and revisions to existing production systems. Key responsibilities include developing an

Job Description: Summary:The Manager Applications Development is responsible for overseeing and evaluating the work of IT staff in both the development of new applications as well as updates fixes and revisions to existing production systems. Key responsibilities include developing an

Job Description: Summary:The Software Engineer is responsible for working on projects that are currently being visualized or developed by our organization. This role will be involved with the Software Development Life Cycle methodology and framework directing software system validatio

Job Description: Summary:The Software Engineer is responsible for working on projects that are currently being visualized or developed by our organization. This role will be involved with the Software Development Life Cycle methodology and framework directing software system validatio

Job Description: Summary:The Network Strategy Planning & Delivery Lead manages crossdivisional strategic initiatives costsaving programs and enterprise planning efforts while ensuring strong coordination with senior leaders and key stakeholders across the organization. This role will

Job Description: Summary:The Network Strategy Planning & Delivery Lead manages crossdivisional strategic initiatives costsaving programs and enterprise planning efforts while ensuring strong coordination with senior leaders and key stakeholders across the organization. This role will

Job Description: Summary:The Provider Program Quality & Integration Consultant facilitates the development and effective implementation of quality and incentive programs and contracts. This work directly impacts the Excellus clinical provider network and member populations. As an indi

Job Description: Summary:The Provider Program Quality & Integration Consultant facilitates the development and effective implementation of quality and incentive programs and contracts. This work directly impacts the Excellus clinical provider network and member populations. As an indi

Job Description: Summary:This position is responsible for and participates in a wide range of provider patient and employer initiatives and programs. The pharmacist supports all of our lines of business which include Medicare Commercial Exchange (Marketplace) and Medicaid. The focus o

Job Description: Summary:This position is responsible for and participates in a wide range of provider patient and employer initiatives and programs. The pharmacist supports all of our lines of business which include Medicare Commercial Exchange (Marketplace) and Medicaid. The focus o

Job Description: Summary:This position is responsible for the accurate and thorough claim and clinical investigation of potential claim payment integrity issues involving all lines of business. This position investigates and remediates claim overpayments creating data and reporting an

Job Description: Summary:This position is responsible for the accurate and thorough claim and clinical investigation of potential claim payment integrity issues involving all lines of business. This position investigates and remediates claim overpayments creating data and reporting an

Job Description: NOTE: We currently have two openings for this role across the enterprise one with an affiliate company CDPHP (Capital District Physicians Health Plan) and one with Excellus BCBS/Univera Healthcare (depending on candidates geographic location).The selected candidate

Job Description: NOTE: We currently have two openings for this role across the enterprise one with an affiliate company CDPHP (Capital District Physicians Health Plan) and one with Excellus BCBS/Univera Healthcare (depending on candidates geographic location).The selected candidate

Job Description: Summary:The Large Group Underwriter is responsible for determining acceptability of insurance risks and appropriate premium rates for large and complex group cases as well as managing the experience rated block of business to produce desired MLR and profit targets. Th

Job Description: Summary:The Large Group Underwriter is responsible for determining acceptability of insurance risks and appropriate premium rates for large and complex group cases as well as managing the experience rated block of business to produce desired MLR and profit targets. Th

Job Description: SummaryThe Accounts Payable Specialist reconciles and pays all approved expenditures for Lifetime Healthcare Companies in an accurate and timely manner duties include but not limited to invoice and employee expenses and auditing scanning entry and payment processing.

Job Description: SummaryThe Accounts Payable Specialist reconciles and pays all approved expenditures for Lifetime Healthcare Companies in an accurate and timely manner duties include but not limited to invoice and employee expenses and auditing scanning entry and payment processing.

Job Description: Summary:The Database Administrator will provide enterprise-wide administration and production support for corporate databases. This position will be responsible for installing testing configuring monitoring performance tuning security and developing evaluation plans e

Job Description: Summary:The Database Administrator will provide enterprise-wide administration and production support for corporate databases. This position will be responsible for installing testing configuring monitoring performance tuning security and developing evaluation plans e

Job Description: Summary:The Manager of Provider Relations manages the staff that serves as the primary contact for participating Providers. This includes managing the internal and external operations of the department training prioritizing assignments auditing and interacting with ex

Job Description: Summary:The Manager of Provider Relations manages the staff that serves as the primary contact for participating Providers. This includes managing the internal and external operations of the department training prioritizing assignments auditing and interacting with ex

Job Description: Summary:The position is responsible for collaborating with leaders across a 2000 person organization to support strategy around how to drive organizational effectiveness through collaboration sharing best practices ensuring effective change management productivity and

Job Description: Summary:The position is responsible for collaborating with leaders across a 2000 person organization to support strategy around how to drive organizational effectiveness through collaboration sharing best practices ensuring effective change management productivity and

Job Description: Summary:This position is responsible for ensuring projects and initiatives within the portfolio meet objectives by increasing employee adoption/usage of the changes to business process systems and technology roles organizational structures and more. The Portfolio Chan

Job Description: Summary:This position is responsible for ensuring projects and initiatives within the portfolio meet objectives by increasing employee adoption/usage of the changes to business process systems and technology roles organizational structures and more. The Portfolio Chan

Job Description: Summary:The position is primarily responsible for the overall relationship and management of the Provider-Vendor agreement account. This position is responsible for the building and maintaining of favorable relationships with these entities; coordinating internal reso

Job Description: Summary:The position is primarily responsible for the overall relationship and management of the Provider-Vendor agreement account. This position is responsible for the building and maintaining of favorable relationships with these entities; coordinating internal reso

Job Description: Summary:Conducts case management program activities in accordance with departmental corporate NYS Department of Health (DOH) Centers for Medicaid & Medicare Services (CMS) Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation

Job Description: Summary:Conducts case management program activities in accordance with departmental corporate NYS Department of Health (DOH) Centers for Medicaid & Medicare Services (CMS) Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation

Job Description: Summary:The Medical Record Retrieval Specialist I/II is responsible for the retrieval of medical records from various healthcare facilities.Essential Accountabilities:Level I Accurately and efficiently retrieves medical records via remote EMR access fax and/or on-site

Job Description: Summary:The Medical Record Retrieval Specialist I/II is responsible for the retrieval of medical records from various healthcare facilities.Essential Accountabilities:Level I Accurately and efficiently retrieves medical records via remote EMR access fax and/or on-site

Job Description: Summary:This role leads the strategic vision roadmap and execution of the Candesa UM product driving innovation and ensuring strong alignment with organizational goals. As a crossfunctional connector the position partners closely with teams across the organization to

Job Description: Summary:This role leads the strategic vision roadmap and execution of the Candesa UM product driving innovation and ensuring strong alignment with organizational goals. As a crossfunctional connector the position partners closely with teams across the organization to

Job Description: Summary:Conducts case management program activities in accordance with departmental corporate NYS Department of Health (DOH) Centers for Medicaid & Medicare Services (CMS) Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation

Job Description: Summary:Conducts case management program activities in accordance with departmental corporate NYS Department of Health (DOH) Centers for Medicaid & Medicare Services (CMS) Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation

Job Description: The Medical Director participates in the broad array of activities of the Medical Services area including but not limited to Medical and Pharmacy Utilization Management quality management member care management and medical policy processes and support for our various

Job Description: The Medical Director participates in the broad array of activities of the Medical Services area including but not limited to Medical and Pharmacy Utilization Management quality management member care management and medical policy processes and support for our various