CDPHP

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 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 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 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: 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: 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 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: 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 Customer Care Advocate (CCA) resolves customer inquiries via telephone, walk in, mail, fax, web chat, off-phone work, and email concerning, but not limited to, contract benefits, claim payments, and enrollment in accordance with LOS, Corporate Service strategy, NCQA, and legislative requirements. The Customer Care Advocate provides service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance member & provider satisfaction/retention. The B version of this role requires the individual to speak Spanish fluently. Essential Responsibilities/Accountabilities: All Levels Provides service among the customers and business partners while responding in a professional, efficient, and timely manner to enhance member and provider satisfaction and retention. Must exercise tact, patience, and professionalism at all times in responding to internal/external customers. Documents,...

Job Description: Summary: The Document Solutions team focuses on the design and creation of correspondence and transactional statements using various software programs. The Publishing Systems Engineer operates in a business analyst/document-generation specialist role as part of the Document Solutions team. This role focuses on programming within the various systems utilized by our Solutions Team. Essential Primary Responsibilities/Accountabilities: Level I: Develops code; analyzes, researches, and resolves system issues for electronic publishing-related problems. Creates, maintains, and follows all documented processes and standards. Builds new and updates existing workflows and documents using xml and text data in variable data composition systems based on the requirements and functional specifications. Documents functional specifications and solutions for work to be performed. Develops or assists in the development of systems testing and implementation plans. Reviews...

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: This position assists the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. This role supports the HARP line of business. Essential Accountabilities: Level I Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for capitated providers. Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,...

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 Administrative Assistant provides comprehensive administrative and operational support to ensure the efficient operations of teams across the organization. This role is responsible for managing schedules and calendars, coordinating internal and external communications, preparing and maintaining documents and reports, and supporting day‑to‑day office and business activities. The position also assists with meeting coordination, information flow, and process organization, helping leaders and teams stay focused on priorities while ensuring accuracy, timeliness, and a high level of professionalism in all interactions. Essential Accountabilities Performs general administrative duties such as data entry, filing, copying, scanning, and document preparation. Manages calendars, schedules meetings, and coordinates logistics for team activities. Answers phones, routes inquiries, and responds to routine emails. Prepares basic reports, correspondences, and...

Job Description: This position will support a book of business in our eastern service region (Syracuse, Utica, Southern Tier, Watertown and the North Country) Summary: This position is primarily responsible for the overall management of strategic and national accounts. This includes but is not limited to acting as a strategic advisor to support clients in the decision making process relative to benefit design, financial impacts, member experience, and industry trends. This role will focus on account retention activities and could expand to include prospecting of new business opportunities. Essential Accountabilities: Level I • Responsible for sales activities, including retention, prospecting, and cross-selling. • Establishes, develops, and maintains positive business relationships with clients, brokers, and internal department contacts. • Develops a thorough understanding of clients strategic goals, financial position and opportunities to offer solutions that meet...

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 Business Systems Analyst is a critical role in the delivery of products for Lifetime Healthcare Companies. This position collaborates with stakeholders throughout the organization to understand business objectives and defines IT system requirements and specifications for the implementation of IT system solutions. The Business Systems Analyst will serve as the primary interface between the business and IT teams to gather, document and analyze all level of requirements with the emphasis on delivering functional and non-functional requirements to solution architects and IT teams. Business Systems Analyst, in collaboration, with their stakeholders sets scope for work items. The Business Systems Analyst position is an excellent opportunity to be a part of a cross-functional team working across the enterprise, on enterprise services. We are looking for an individual who has prior, hands-on experience as a back-end software developer, to best partner...

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...