Rochester Careers Head
  • Help Desk Technician 
  • 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.
  • Health Analyst 
  • 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 
  • 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 
  • 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.