This position is responsible for completing utilization management (UM) for all gender affirming services (GAS) requests for our Transgender/ Non Binary members. Responsibilities Coordinate, in conjunction with Clinical Services, Utilization Management (UM) determinations in accordance with Article 49 Utilization Review. Ensure UM is completed by following all regulatory

As the Manager of Vendor Management, you will play a pivotal role in advancing our mission with improving our customer experience by providing a mature vendor oversight process and cadence to enhance our vendor relationships and performance. Responsibilities Ensure vendors effectively meet and exceed the service levels and key performance indicators we use to ensure effic

This position serves as an integral part of her/his assigned Integrated Care Team (ICT) and is responsible for coordination of services related to the delivery of medical benefits that ensure members' complex medical, behavioral, pharmaceutical, and psychosocial needs are met within the established benefit policies and guidelines for the treatment and evaluation of member

The Senior Claims Analyst assists management to ensure accurate, timely and proper execution of claims. Assists in quality control and accuracy for claims payments performed by Amida Care's TPA and other specialty vendors. This position will identify opportunities and challenges associated with the end to end claims processing life cycle and provide support and resolution

This position serves as an integral part of a specialized Integrated Care Team (ICT) that is responsible for intensive care management for High Risk members with a focus on children/adolescent members and pregnant/post partum members. The Care manager's role is to ensure members' complex medical, behavioral, pharmaceutical, and psychosocial needs are met within the establ

This position supports the Integrated Care and Behavioral Health area of health services through oversight and organization of administrative efforts, including but not limited to, vendor relations, tracking, coordinating and management of implementation of new benefits; tracking of departmental and cross functional initiatives; liaises with appropriate support department

The Driver is responsible for maintaining an efficient, well organized community outreach vehicle (COV). The Driver is accountable for the day to day operations on the assigned COV, responsible for all marketing & promotional materials on the assigned COV, the ordering of all supplies needed to maintain the COV, daily set up and break down and the interior cleanliness and

The Vice President of Information Technology is a member of the Amida Care Senior Leadership team and serves as a strategic, innovative and best practice driven thought leader on all technology matters. The VP of IT is responsible for the oversight of planning, developing, implementing, securing, and operating the organization's information technology (IT) systems. The VP

The Information Technology Operations Architect Network is responsible for the design (blueprint), creation and deployment of Amida Care's networking technology (end to end solution architecture). He/she/they provide(s) technical expertise in the use of technology and is accountable for the overall performance of the enterprise's solutions while ensuring these solutions w

This position develops, contracts, maintains, and enhances relationships with key high volume facilities and physicians to drive business results. This position is responsible for the appropriate representation of providers relating to contractual arrangements, compliance, regulatory, credentialing, claims, provider files and administrative policy and procedures. This pos

The Information Technology Operations Architect Desktop is responsible for the design (blueprint), creation, and deployment of Amida Care's desktop, laptop, and printer technology solutions (end to end solution architecture). The Information Technology Operations Architect Desktop provides technical expertise in the use of technology and is accountable for the overall per

The Member Services Representative position supports the Member Services Departments goal and mission to deliver the highest level of customer service and support for members and providers in a call center setting. The Member Services Representative is responsible to answer and resolve high volume of member and provider inquires, concerning benefits, services, and claims.

Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well being for our members. This true integrative