All Careers Head
  • Help Desk Technician-Rochester 
  • The Help Desk Technician is responsible for supporting staff in using business software, operating systems, and computer hardware. Under supervision from Network Administrators, a person in this position will also assist with the configuration of computer hardware, operating systems, and business software. The position requires the identification, research, and resolution of technical problems in response to requests for technical support. Qualifications: The ideal candidate will have a bachelor’s degree in information systems, computer science, or equivalent experience. Although formal certification, through the A+ or Microsoft curriculums, is not required, it is preferred. Specific skills should include experience with Microsoft Office, Windows XP/7 and Windows Server 2003/2008. Outstanding customer service skills a must.
  • Provider Relations Supervisor-Syracuse
  • The Provider Relations Supervisor is responsible for maintaining excellent relationships with participating provider offices, recruits new providers, prepares management reports on network adequacy issues and resolutions; develops and implements strategies to expand network participation, and manages PR staff. Qualifications: 5-7 years solid provider relations experience, knowledge of local health care delivery system, excellent verbal, written and presentation skills and a Bachelors degree. Management experience preferred.
  • Provider Relations Representative-Syracuse 
  • The Provider Relations Representative is responsible for interacting with participating providers and staff by orienting new providers, providing ongoing training, proactively identifying and solving problems. This role also helps expand the provider panel through marketing, generates reports, assists with database management, and is an active member on community provider interest groups. Qualifications: Minimum of 5 years managed care experience in provider relations or customer service, and familiarity with local health care delivery systems. Excellent verbal, written, and presentation skills and computer literate. Valid NYS drivers license. Local travel required.
  • Health Analyst-Rochester 
  • The Health Analyst is responsible for supporting disease, utilization, population and health risk management activities, by developing cost effectiveness and ROI analyses, implementing outcomes measurement systems and ad hoc analytical reporting. This position also works with a database administrator to create analytically relevant database designs. Qualified candidates should possess: An advanced degree in a health care related field or a master’s degree in computer science and/or equivalent analytical and programming expertise related to health care systems.  A minimum of two years experience in healthcare and/ or demonstrate the capacity to develop analytical expertise in new knowledge domains.  Experience with applied statistical reasoning, as demonstrated by coursework or previous work.  Competency in SQL databases. Transact-SQL desirable experience.
  • Utilization Review Nurses-Rochester 
  • The Utilization Review Nurse seeks to enhance our member's access to care and services while maintaining maximum quality and service value. The UR Nurse reviews requests for referrals, prior authorizations and claims adjustments to determine whether health care services that have been provided, are being provided, or are proposed to be provided to a member are medically necessary or experimental /investigational. Qualified candidates must possess a current NYS registered nursing licensure and have a minimum of two years nursing experience in general medicine/surgery/home care agency. Strong computer and typing skills and the ability to learn/use various hardware & software to perform daily activities such as QWS (TOPSS) system & Lotus Notes. Knowledge of HCPCS and CPT, ICD9 codes a plus.
  • Customer Service Representative-Rochester 
  • The Customer Service Representative is responsible for researching, interpreting and responding to telephone, fax, or written inquiries from members, providers of health care, and business partners in accordance with Medicaid, corporate service strategy and legislative requirements. Requires the problem solving skills necessary to accurately and efficiently resolve customer inquiries in an organized manner and maintain acceptable production levels. Must be an effective and diplomatic oral communicator with good listening skills, and a sincere desire to help a diverse customer population. Strong computer skills, a high school diploma, and customer service experience are necessary.
  • Perinatal Case Manager-Buffalo 
  • The Perinatal Case Manager provides case management to members with high risk or complex medical and psychosocial problems through community and home based visits, and telephonic support. This role also links member to appropriate care services, and communicate with providers in order to reduce health disparities and improve health care outcomes for the member. Qualified candidates must possess a current Professional Nursing Registration and a minimum of 3 years experience in case management and/or recent acute care and/or community health nursing in the field of women’s health and pediatrics. Candidates must also have knowledge of community resources, health care services and clinical standards especially those relating to the needs of women and children, as well as current best practices in the areas of management of pregnancy, post-partum, lactation and pediatrics. Excellent communication skills, ability to work independently, strong organizational and computer skills, and a current driver’s license and access to a vehicle during work day is required.