• Case Manager , Medicaid

    MVP Health Care (Schenectady, NY)
    …requires innovative thinking and continuous improvement. To achieve this, we're looking for a ** Case Manager , Medicaid Long Term Support Program** to ... Case Management experience. Experience working in a Medicaid Long Term Support Program (LTSS) or... Medicaid members. + Through collaborative efforts the Case Manager will identify the medical and… more
    MVP Health Care (11/16/25)
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  • Case Manager - Adult Residential…

    Equinox, Inc (Albany, NY)
    Case Manager - Adult Residential Services Albany, NY (http://maps.google.com/maps?q=Albany+NY+USA) Job Type Full-time Description Equinox is a non-profit human ... mental illness and an addiction that need 24/7 support. Position Summary: The Residential Case Manager is responsible for providing service plan development and … more
    Equinox, Inc (10/31/25)
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  • Senior Case Manager

    Cardinal Health (Albany, NY)
    …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient ... expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare, … more
    Cardinal Health (11/12/25)
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  • Access and Patient Support: Case

    Cardinal Health (Albany, NY)
    …Remain knowledgeable about changes in the reimbursement environment (Medicare, Medicaid , Managed Care, Commercial plans). **Program Expertise & Continuous ... and develop effective solutions. . Provide guidance and training to junior case managers on best practices. **Communication & Collaboration** . Provide world-class… more
    Cardinal Health (10/29/25)
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  • RN Care Manager - Remote, nationwide

    Humana (Albany, NY)
    …of the business there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare, Medicaid , and/or and Group ... community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies,...EST.** Our nurses are titled Care Managers, because our case management services are centered on the person rather… more
    Humana (11/19/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Albany, NY)
    …Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), ... denial decisions. * Resolves escalated complaints regarding utilization management and long -term services and supports (LTSS) issues. * Identifies and reports… more
    Molina Healthcare (11/14/25)
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  • Medical Management Specialist I

    Elevance Health (Latham, NY)
    …areas. **How you will make an impact:** + Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization ... Skills and Experiences:** + Understanding of managed care or Medicaid /Medicare strongly preferred. + Previous experience in healthcare administration, service… more
    Elevance Health (11/15/25)
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  • PCO Medical Director- UM - Full Time

    CenterWell (Albany, NY)
    …teams focusing on transitions of care, quality management,utilizationmanagement, case management, discharge planning and/or home health or post-acute ... of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/… more
    CenterWell (11/06/25)
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  • Registered Nurse 1

    New York State Civil Service (Schenectady, NY)
    …collaborates with interdisciplinary team members to promote optimal health outcomes. The Nursing Case Manager also serves as a liaison between medical providers, ... CPR compressions on the floor would ensure nurse ability to perform in worst case scenario, since we use no backboards in OPWDD.SELECTION PROCESS: Selection will be… more
    New York State Civil Service (11/14/25)
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  • Sr. Consultant, Change Management

    Cardinal Health (Albany, NY)
    …successful implementation. . Build strong partnerships across Patient Access, Case Management, Specialty Hubs, Pharmacy Operations, IT, and executive leadership. ... appealing and compelling communications (infographics, Veeva Engage posts, slides, manager huddle scripts) tailored to diverse audiences-from frontline teams to… more
    Cardinal Health (11/15/25)
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  • Director, System Payer Contracting (On-site)

    Albany Medical Center (Albany, NY)
    …and hospital clinical leadership, legal, compliance, billing, finance, IT, case and utilization management, quality, credentialing, and other related departments. ... value-based enterprise financial acumen + Demonstrated leader of people and manager of resources. + Demonstrated success in orchestrating, leading, and overseeing… more
    Albany Medical Center (11/13/25)
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