Univera HealthСare

Job Description: Summary: The Summer College Internship Program is a 10-week paid internship experience that provides undergraduate and graduate students with the opportunity to attend development workshops, network, and be part of our company. Our college interns work on meaningful projects, are mentored under their respective managers, and continue to develop throughout the entire summer. Through the internship program, our interns can attend development workshops that are focused on key business concepts. Interns may work within the skills-based tracks of Business Administration, Information Technology, Actuarial, Human Resources, Analytics & Data, Communications, Finance, Marketing & Sales, Project Management, Clinical Studies, Customer Experience, Digital Operations, and other non-technical and/or technical based degree programs. This is a paid 10-week summer internship from the first Monday in June to the second Friday in August (up to 40 hours per week)....

Job Description: Summary: This role provides the vision, strategy, functionality, and technology solutions for creating and maintaining distributed platforms for both public and private cloud infrastructure-based solutions. This entails the design and use of flexible platforms that deliver features, functionality, and services compatible with industry-leading providers while allowing legacy systems to interact safely when required. This position requires the necessary skills to provide technology research, evaluation, development, and delivery in support of infrastructure deployment solution lifecycles. This position collaborates with the Information Technology teams to lead the organization toward the deployment of technologies that may include PaaS, SaaS, hosted, and on-premises solutions - which will allow for flexible, secure, on-demand cloud-like functionality and services while endeavoring to provide resiliency and achieve cost reduction, while maintaining a highly...

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 validation and testing methods, as well as directing software programming initiatives. This position works closely with clients and cross-functional departments to communicate project statuses and proposals. The position requires a strong proficiency in oracle development focusing on stored procedures and SQL scripting. Additionally, experience with Informatica and ETL is strongly desired. Essential Accountabilities: Level I • Develops code, analyzes, researches, and resolves associated system issues. • Participates in on-call production support rotation. • Supports, maintains, creates and follows all documented IT processes and standards, application documentation and design and code reviews....

Job Description: Summary The Executive Assistant provides high‑level administrative, strategic, and operational support to senior leadership to ensure the smooth and effective execution of key priorities. This role serves as a trusted partner to the senior leaders, proactively managing complex and dynamic calendars, coordinating internal and external communications, and acting as a key point of contact for stakeholders. The Executive Assistant handles highly sensitive and confidential information with discretion, prepares materials and briefings to support decision‑making, and facilitates meetings, travel, and key initiatives. In addition, this role anticipates needs, streamlines workflows, and helps align day‑to‑day activities with broader organizational goals, enabling leaders to focus on strategic outcomes. Essential Accountabilities Provides comprehensive, day-to-day executive administrative support to senior leaders and/or division. Anticipates needs, proactively...

Job Description: Summary: The Salesforce Administrator will be responsible for managing the day-to-day operations, configuring Salesforce to fit the company's needs, creating, and managing fields, views, reports, dashboards, campaigns, and other Salesforce objects and functions specific to the betterment and optimization of the enterprise's provider lifecycle management (PLM) experience. This role has a solid understanding of business operations as well as strategy and the analytical capabilities to translate business needs into system solutions. Salesforce Administrator is responsible for managing and developing the salesforce.com platform to meet the provider network engagement's business needs. This role is to ensure the stability and scalability of the system, design and implement new features, and offer support and training to users. Essential Accountabilities: Level I • Collaborates with provider network leaders as well as their teams, Salesforce & Product...

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 standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential...

Job Description: The Salesforce Developer is responsible for utilizing agile development methodologies to analyze, develop, and test system solutions in response to business requirements. Incumbents are expected to understand user stories, identify appropriate designs, code to the design specifications, and complete appropriate unit testing to ensure a quality solution delivery. Working with stakeholders across a broad array of IT and business teams through all phases of a project, including requirements-definition, design and build, delivery, and user acceptance testing, the Developer leverages industry expertise to consult on and influence project direction, as a tireless advocate for best practices. The incumbent demonstrates commitment to project success by ensuring that the delivered product is fully-functioning, performs to business requirements defined and approved by the team, and meets or exceeds stakeholder expectations. Essential Accountabilities Level I...

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 and maintaining relationships with business stakeholders to understand their operating processes, challenges, and strategic plans - in order to ensure the appropriate technologies are developed and implemented. Additional responsibilities include supporting the team in monitoring and maintaining system uptime and availability as well as driving appropriate response times for service requests - ensuring that production incidents remain in-line with defined service level agreements. The Manager is also responsible for driving the planning, coordination, and execution of development and implementation of strategic technical solutions for their application portfolio. This includes the analysis of...

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 timely monitoring, responding, and troubleshooting of incidents, installing, upgrading, and maintaining application currency. This position will work to identify functionality to empower users through self-service and automation of relevant tasks. In addition to operating as application support, the IT Platform Administrator will perform periodic audits and maintain application compliance. The Administrator also frequently interacts with multiple departments to advocate for stakeholders' and platform best interests. This position is a great opportunity to work with a cross-functional application support team! We are looking for someone who has solid experience with Databricks to round out our...

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 department projects, staffing, etc. This position provides CM representation at various internal and external meetings. This individual will lead a dynamic team of Dietitians and Respiratory Therapists while driving innovation that enhances care delivery and operational excellence. This high-impact role combines people leadership, workflow development, and the opportunity to champion exciting initiatives that shape the future of the organization. Essential Accountabilities: Provides direction and supervision to the CM staff including departmental function, individual development plans, performance reviews, and disciplinary actions. Responsible for coordinating communications and daily...

Job Description: Summary The AI Engineer is part of a highly collaborative team that develops cutting-edge machine learning (ML) and artificial intelligence (AI) models to solve complex business challenges and improve member health outcomes. In this role, you will work on high-impact projects involving advanced ML techniques, including large language models (LLMs) and generative AI. You'll have the opportunity to experiment with state-of-the-art algorithms, push the boundaries of AI capabilities, and contribute to innovative solutions that drive real-world value. Essential Accountabilities Level I Develops Artificial Intelligence and Machine Learning solutions to solve business problems and improve member health outcomes, incorporating (but not limited to): Large language models (LLMs) and generative AI applications, machine learning models, natural language processing (NLP), optimization and mathematical programming and recommendation systems. Builds and refines data...

Job Description: Summary: The Business Consultant serves as a strategic partner between the Health Plan and its internal and external clients, leveraging data-driven insights to guide decision-making and improve healthcare outcomes. This role fosters a multidisciplinary approach by collaborating across departments including Sales, Pharmacy, Medical Services and Workplace Wellness to create a centralized reporting function. The consultant translates complex data into actionable recommendations that drive cost savings, enhance quality, and support organizational goals. Essential Accountabilities: Level I Analyze enterprise-wide trends and present insights to senior leadership and internal and external clients to inform strategic decisions. Serve as the primary point of contact for consulting engagements, ensuring alignment with internal and external client needs and expectations. Act as a liaison across internal departments to coordinate unified strategies aimed at...

Job Description: Summary: This position supports the workflow of the Medical Services division. The Medical Services Coordination Specialist provides support for any of the programs of Behavioral Health, Quality Management, or Member Care Management. This position is responsible for adhering to certain regulatory requirements as well helping to support and connect members to appropriate internal Health Plan resources, Clinical Case Management team and external community support systems. Essential Accountabilities: Level I Review and prep clinical case for clinical staff. Assesses member's needs by applying Health Plan approved case management guidelines and assessment tools. Makes appropriate referrals to clinical programs. Collaborates with the clinical care team to support enrollees. Works with enrollee/caregiver/legal guardian to identify and achieve shared treatment goals. Manages a caseload productively and keeps appropriate documentation according to health...

Job Description: Summary: The incumbent directs the team responsible for maintaining the integrity and quality of the provider files. This role oversees the training, coordination of all departmental workflows, prioritization of assignments, interaction with external customers as well as effectively communicating requirements amongst various cross-divisional teams. The Supervisor effectively leads the Provider File Management (PFM) team in such a way as to ensure quality delivery within time and budget constraints. Essential Accountabilities: Supervises technical and analytical work of assigned PFM staff. Interviews, selects and trains staff to achieve or exceed established standards of performance. Monitors and coaches PFM employees. Coordinates the prioritization and scheduling of work assignments and projects, including oversight of and responsibility for all provider file activity and day to day operations of the unit. Initiates and leads analyses within the...

Job Description: Summary: The incumbent acts as a point person for the Enterprise Project Management Organization (EPMO) division with regards to programs they work on an as well as working to understand the impact of other projects to their division. The position leverages the ability to form relationships, understanding dependencies and assessing impacts that allows the Consultant to guide their daily efforts and success in the role. The work supports Corporate Strategic Projects, Divisional Initiatives, Resource and Capacity planning, Project Methodology and Governance, Reporting and application support for related programs as selected by the organization. Examples of engagement will be to align internal and external communications on Strategic Projects, efforts to close gaps that get in the way of successful project delivery and insights from data compiled via the resource and capacity planning tool. The Consultant prepares information in a shareable format to enable both...

Job Description: Summary: The Information Security & Cybersecurity Engineer role develops, maintains, and coordinates the Organization's information security activities in support of the Lifetime Healthcare Companies' information security program. This position provides technical information security risk management and compliance services and support to the Organization's lines of business and further provides information security consulting and support to all levels of the Organization's management in support of the information security program. The cybersecurity disciplines range from Security Operations, Governance Risk and Compliance services, or Identity and Access Management. Essential Accountabilities: Level I • Responsible for the design, implementation, and operation of Organization-wide security infrastructures. Evaluates and proposes new security solutions and advises and consults with the security manager and various levels of management regarding...

Job Description: Under the direct supervision of a licensed pharmacist, the Managed Care Pharmacy Technician (Pharmacy Tech) is responsible for administering CDPHP member and client-specific programs aimed at optimizing pharmacy benefits and the prescription process. This position will handle live calls to members as well as physicians and pharmacists, to provide information regarding pharmacy benefits, formulary coverage and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed pharmacist. The pharmacy tech is responsible for implementing and monitoring the technical aspects of pharmacy benefits including the processing of medical exception requests using approved clinical algorithms, advising on pharmacy matters from internal and external sources, as well as additional ad hoc project work which supports the pharmacy department. The pharmacy tech will participate in an on-call/holiday rotation along...

Job Description: This position is responsible for coordinating, integrating, and monitoring the utilization of behavioral health (BH) or physical health (PH) services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as required, to meet departmental time frames. Per department needs, may be responsible for additional hours. Essential Accountabilities: Level I Performs pre-service, concurrent and post-service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members' behavioral health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical review...

Job Description: Summary: The Business Assurance Testing Analyst oversees business testing and User Acceptance Testing (UAT) for projects, releases, and system changes. This role develops and manages test plans, coordinates testing with business and technical teams, tracks defects and issues, reviews results, and supports business sign-off before deployment. The position helps ensure solutions meet business needs, quality standards, and readiness expectations. Hiring Team: Brian Cocozza Kirk Juhas Essential Accountabilities: Leads business testing, User Acceptance Testing (UAT), and validation efforts from planning through completion to confirm solutions meet business requirements, quality standards, and release readiness expectations. Develops and maintains test strategies, test plans, test cases, scripts, scenarios, and supporting documentation aligned to business requirements, functional requirements, acceptance criteria, change management and system...

Job Description: Summary: The Senior Medical Director is a strategic clinical and business leader responsible for advancing the health plan's line of business focus through value-based care, population health, medical management, quality improvement, risk adjustment, product design, and clinical transformation. This role partners closely with line of business leadership, network and provider contracting, actuarial, finance, quality, pharmacy, analytics, care management, and operations to improve clinical outcomes, member experience, provider performance, and total cost of care while ensuring compliance with CMS requirements. Essential Accountabilities: Serve a senior clinical advisor to line of business leadership on strategy, population health, medical cost, quality, and regulatory priorities, develop and execute clinical strategy in alignment with organizational growth, quality, and financial objectives. Identify clinical and market opportunities to improve member...