Univera Healthcare

Job Description: Summary:The Sourcing Analyst is responsible for the design development and presentation of detailed analysis to support critical sourcing activities and special projects. This includes development of tools and templates to streamline sourcing initiatives. The incumben

Job Description: Summary:The Sourcing Analyst is responsible for the design development and presentation of detailed analysis to support critical sourcing activities and special projects. This includes development of tools and templates to streamline sourcing initiatives. The incumben

Job Description: Summary:The Account Service Consultant ensures prompt accurate and efficient servicing of the Medicare Sales team which include Medicare Advantage Medicare Supplement and Prescription Drug Plans (PDPs). Inquiries received by an Account Service Consultant may be via on

Job Description: Summary:The Account Service Consultant ensures prompt accurate and efficient servicing of the Medicare Sales team which include Medicare Advantage Medicare Supplement and Prescription Drug Plans (PDPs). Inquiries received by an Account Service Consultant may be via on

Job Description: Summary:The Service Control/Operations Methodology at Excellus generally consists of the following disciplines:Asset and Configuration ManagementIncident/Problem/Change ManagementService DeskThe Asset-Configuration Management Analyst is specific to the Asset and Confi

Job Description: Summary:The Service Control/Operations Methodology at Excellus generally consists of the following disciplines:Asset and Configuration ManagementIncident/Problem/Change ManagementService DeskThe Asset-Configuration Management Analyst is specific to the Asset and Confi

Job Description: Summary:The Information Security & Cybersecurity Engineer role develops maintains and coordinates the Organizations information security activities in support of the Lifetime Healthcare Companies information security program. This position provides technical informati

Job Description: Summary:The Information Security & Cybersecurity Engineer role develops maintains and coordinates the Organizations information security activities in support of the Lifetime Healthcare Companies information security program. This position provides technical informati

Job Description: Summary:This role provides strategic clinical and operational leadership for the Candesa Utilization Management (UM) program driving innovation and ensuring strong alignment with organizational goals. As the senior clinical authority for Candesa UM this position sets

Job Description: Summary:This role provides strategic clinical and operational leadership for the Candesa Utilization Management (UM) program driving innovation and ensuring strong alignment with organizational goals. As the senior clinical authority for Candesa UM this position sets

Job Description: Summary:The Actuarial Analyst performs actuarial services in support of Health Plan operations and monitors and maintains financial solvency through the understanding of current data & environment and modeling of future events. This role is amongst the group that is r

Job Description: Summary:The Actuarial Analyst performs actuarial services in support of Health Plan operations and monitors and maintains financial solvency through the understanding of current data & environment and modeling of future events. This role is amongst the group that is r

Job Description: Summary:The Financial Analyst is responsible for recording financial data and assisting in the preparation and analysis of various financial records and statements used to monitor and measure business activity within the limits of established practices policies and pr

Job Description: Summary:The Financial Analyst is responsible for recording financial data and assisting in the preparation and analysis of various financial records and statements used to monitor and measure business activity within the limits of established practices policies and pr

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:Under the guidance of the SIU Management this position is responsible for the accurate and thorough clinical investigation of potential fraud waste and abuse (FWA) for all lines of business. The scope of accountability includes investigating and remediating al

Job Description: Summary:Under the guidance of the SIU Management this position is responsible for the accurate and thorough clinical investigation of potential fraud waste and abuse (FWA) for all lines of business. The scope of accountability includes investigating and remediating al

Job Description: Summary:This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. This position acts as a resource for both internal and external customers through completing timely and accurate inbound and/or outbound

Job Description: Summary:This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. This position acts as a resource for both internal and external customers through completing timely and accurate inbound and/or outbound

Job Description: Summary:The Manager of Accounting & Financial Reporting is responsible for designing implementing and maintaining appropriate policies and procedures to ensure accurate and timely monthly quarterly and annual financial reporting which is compliant with GAAP Statutory

Job Description: Summary:The Manager of Accounting & Financial Reporting is responsible for designing implementing and maintaining appropriate policies and procedures to ensure accurate and timely monthly quarterly and annual financial reporting which is compliant with GAAP Statutory

Job Description: Summary:Under general supervision of the Assigned Management this position is responsible and accountable for the management of pharmacy finance analytics reporting and pricing strategy to support the attainment of corporate growth and margin targets for the Pharmacy

Job Description: Summary:Under general supervision of the Assigned Management this position is responsible and accountable for the management of pharmacy finance analytics reporting and pricing strategy to support the attainment of corporate growth and margin targets for the Pharmacy

Job Description: Summary:The Healthcare Statistical Analyst performs technical services within the actuarial or risk adjustment department that support of the Health Plans operations which monitors and maintains financial solvency through the understanding of current data & environmen

Job Description: Summary:The Healthcare Statistical Analyst performs technical services within the actuarial or risk adjustment department that support of the Health Plans operations which monitors and maintains financial solvency through the understanding of current data & environmen

Job Description: Summary:Under the general direction of the Assigned Management and in accordance with sound and ethical procedures objectives and controls a Network Services Analyst analyzes and evaluates the composition and characteristics of Health Plan provider networks. This posi

Job Description: Summary:Under the general direction of the Assigned Management and in accordance with sound and ethical procedures objectives and controls a Network Services Analyst analyzes and evaluates the composition and characteristics of Health Plan provider networks. This posi

Job Description: Summary:The IT Platform Administrator acts as a liaison between the business and technical resources by ensuring the availability and successful operation of applications for users. This individual will demonstrate a high-level of responsibility and consistency by tim

Job Description: Summary:The IT Platform Administrator acts as a liaison between the business and technical resources by ensuring the availability and successful operation of applications for users. This individual will demonstrate a high-level of responsibility and consistency by tim

Job Description: NOTE: This position is aligned to support IT Vendor Management for our Analytics Data Technology & Digital (ADT&D) division. Summary:This role is accountable for strategically managing vendor portfolios and vendor relationships for assigned internal business organizat

Job Description: NOTE: This position is aligned to support IT Vendor Management for our Analytics Data Technology & Digital (ADT&D) division. Summary:This role is accountable for strategically managing vendor portfolios and vendor relationships for assigned internal business organizat

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: Thank you for your interest in our Customer Care team. Due to the volume of applications we receive we review all applications in the order in which they were received. If you are chosen to move to the next step in the process you will receive a Video Assessment from

Job Description: Thank you for your interest in our Customer Care team. Due to the volume of applications we receive we review all applications in the order in which they were received. If you are chosen to move to the next step in the process you will receive a Video Assessment from

Job Description: Summary:This position supervises coordinates and is accountable for the daily work of employees who provide case management and clinical related services. The Supervisor facilitates day-to-day operations of the department such as customer requests coordination of depa

Job Description: Summary:This position supervises coordinates and is accountable for the daily work of employees who provide case management and clinical related services. The Supervisor facilitates day-to-day operations of the department such as customer requests coordination of depa

Job Description: Summary:This position assists the Health Plan in establishing a presence in the community through home visits and community outreach bridging the gap between members and the Clinical Operations Department. Community Connections Representatives educate members about ac

Job Description: Summary:This position assists the Health Plan in establishing a presence in the community through home visits and community outreach bridging the gap between members and the Clinical Operations Department. Community Connections Representatives educate members about ac