Artificial Intelligence Content Editor jobs in East Syracuse

Photographer/Video Editor

NewsChannel 9 (WSYR-TV) in East Syracuse, New York, is looking for a Photographer/Video Editor to join our News team. The Photographer/Video Editor operates video and editing equipment to produce images or scenes for newscasts and other programming.Organizes and edits together raw video matching scripts or instructions for newscasts and other programmingSelects and combines the most effective shots of each scene to form a logical and smoothly running storyShoots video for news reportsPartners with reporters to develop creative, visually appealing & impactful storiesMaintains video equipmentEdits video clips for television broadcasts, streaming and Digital contentOperates live Backpack TVU equipmentWorks efficiently and effectively under extremely tight deadlines on a daily basisGood judgment skills are a must.Comprehensive understanding of ethical and legal issues concerning daily newsgathering. Routine use of appropriate journalistic standards and guidelines is a must.Performs other duties as assignedRequirements & Skills:College degree or equivalent related experience is requiredFluency in EnglishExcellent communication skills, both oral and writtenMinimum two years’ experience operating video editing equipmentProficiency with computers, telephones, copiers, scanners, fax machines and other office equipmentProficiency with video editing equipmentAbility to meet deadlines, prioritize assignments and handle multiple tasks simultaneouslyWorking knowledge of Adobe Premier helpfulFlexibility to work any shift, including overnights and weekendsPhysical Demands & Work Environment:Must be able to sit, conduct telephone conversations, use electronic mail, write letters and memos, conduct face-to-face discussions with individuals or groups, make decisions without supervision, make decisions that impact the results of co-workers, work near others, work outdoors occasionally in all weather conditions, and work indoors in environmentally controlled conditions. In addition, must be able to lift, set up and operate equipment weighing up to 25 pounds, and be able to handle, control or feel objects, tools or controls. Repetitive movements are required. Work may be conducted in extremely bright or inadequate lighting conditions.About NewsChannel 9 (WSYR-TV)WSYR-TV/NewsChannel 9 is situated in East Syracuse, New York, just a short distance from Downtown Syracuse and Syracuse University. For those unfamiliar with the Central New York area, our area offers four distinct seasons. Each season is filled with its own unique activities, like apple picking, skiing, boating, festivals, and rooting for the Syracuse Orange year-round. Syracuse, also known as the 'Salt City', strikes an ideal balance between the amenities of a larger city, including events, a diverse range of culinary options in our restaurants, and family-friendly attractions, and the welcoming atmosphere of a smaller town. Our city is rapidly growing, as evident from the developing Inner Harbor area, the newly renovated JMA Wireless Dome, and the significant investments in our infrastructure.COMPENSATION RANGE - $33K - $38K annuallyC ompetitive compensation package with medical, dental, vision, life insurance, 401(K), and moreEEO Statement: Equal Opportunity Employer Minorities/Women/Veterans/DisabledAll employees must first contact their current manager before applying for an Internal position .NewsChannel 9 WSYR-TV is an Equal Opportunity EmployerNexstar Media Group, Inc. (NASDAQ: NXST) is a leading diversified media company that produces and distributes engaging local and national news, sports and entertainment content across its television and digital platforms, including more than 310,000 hours of programming produced annually by its business units. Nexstar owns America’s largest local television broadcasting group comprised of top network affiliates, with 200 owned or partner stations in 116 U.S. markets reaching 220 million people. Nexstar’s national television properties include The CW, America’s fifth major broadcast network, NewsNation, our national news network providing “News for All America,” popular entertainment multicast networks Antenna TV and Rewind TV, and a 31.3% ownership stake in TV Food Network. The Company’s portfolio of digital assets, including its local TV station websites, The Hill and NewsNationNow.com, are collectively a Top 10 U.S. digital news and information property. For more information, please visit nexstar.tv.EEO Statement: All qualified applicants will receive consideration for employment without regard to disability, protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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CNA *NEW RATE*

Sunnyside Care Center East Syracuse, NY

*New Rate $24.97/hour**Shift Differentials**Employee Pension**All Shifts Available*Since 1972, Sunnyside Care Center has been a trusted part of our community. Providing Short-term Rehabilitation and Long-term Care, our dedicated and seasoned team remain focused on the principles of safety, kindness and compassion. It is our privilege to foster an environment, where individuality and dignity are preserved, appreciated and honored.Sunnyside Care Center is actively seeking Certified Nursing Assistants (CNAs) to join our growing team of health care professionals where you will provide outstanding patient care and physical support for our patients and residents on a daily basis.To do well in this role you must have your state-certified nursing assistant certification from a recognized CNA program. Interested? Apply today online or in person. Questions? Call us at 315-627-7200. We can't wait to have you be a member of the Sunnyside team!CNA Responsibilities:Providing great patient care.Answering patient/resident calls and determining how best to help them.Providing physical support for patients or residents with daily activities and personal hygiene, including bathing, dressing, getting out of bed, - using the toilet, walking, standing, or exercising.Turning and repositioning bedridden patients.Ensuring patients or residents receive appropriate diet by reviewing their dietary restrictions, food allergies, and preferences.Obtaining a wide range of information from physicians, caregivers, and nurses about patient conditions, treatment plans, and suggested activities.Measuring and recording food and liquid intake and urinary and fecal output and reporting changes to medical or nursing staff.Recording vital signs, including blood pressure, pulse, temperature, and respiration rate as requested by staff.Examining patients to detect issues requiring medical care, including open wounds, bruises, or blood in the urine.Noting observations of patient behavior, including complaints, or physical symptoms to nurses.Stay up to date on CNA training and facility policy and procedure.Any other duties assigned by the Director of Nursing or designeeJob Types: Full-time, Part-timePay: $24.97 per hourBenefits:Dental insuranceHealth insuranceLife insurancePaid orientationPaid sick timePaid time offPaid trainingVision insuranceMedical Specialty:GeriatricsPhysical Setting:Long term careNursing homeSupplemental Pay:Differential payExperience:CNA: 1 year (Preferred)Long term care: 1 year (Preferred)License/Certification:CNA Certification (Preferred)Ability to Commute:East Syracuse, NY 13057 (Required)Ability to Relocate:East Syracuse, NY 13057: Relocate before starting work (Required)Work Location: In personJob Types: Full-time, Part-timePay: $24.97 per hourLicense/Certification: CNA (Required) Shift availability: All Shifts Ability to Commute: East Syracuse, NY 13057 (Required) Work Location: In person

Dynamic Environment

Medical Investigator I/II (RN Required)

Excellus BCBS East Syracuse, NY

Job DescriptionUnder the guidance of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of business. The scope of accountability includes investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements.Substantiating referrals, case planning and research.Conducting onsite or desk audits.Performing clinical reviews of medical records to ensure correct billing of services and appropriateness of care.Interviewing potential witnesses.Developing corrective action plans.Drafting correspondence to impacted parties.Managing disputes and collaborating with law enforcement and regulatory agencies.Essential AccountabilitiesLevel IFunctions as a clinical reviewer of medical records, researching and investigating complex medical cases. Interprets a variety of documents including provider contracts, group benefit structures, corporate medical policies, the AMA CPT Coding Guidelines, HCPCS coding, inter-plan regulations, government policies, and diverse regulatory and legal requirements.Thoroughly researches allegations or issues and develops sources of information to create a plan of action, accumulating sufficient detailed evidence including statements, documents, records and exhibits. Evaluates situations accurately and interacts with management, medical directors and legal, where appropriate, to ensure complex issues are addressed appropriately.Prepares comprehensive summary reports and assures accuracy of information provided to providers, regulators, law enforcement, Legal, Compliance and outside counsel. Prepares cases for prosecution, civil settlement, or overpayment recoupment by documenting findings in a clear and concise manner.Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns.Manages cases as assigned, prioritizing case load as appropriate. Maintains case logs, prepares records and regular status reports. Interacts with health care providers, often under adverse conditions due to discovery of potential FWA. Discusses sensitive material in a professional, fair and accurate manner. Recommends providers for referral to the New York State Office of Professional Medical Conduct, the New York State Education Department Office of Professional Discipline and/or internal referral for quality review by the applicable business area.Acts as primary point of contact with law enforcement for assigned cases and may be required to prepare files and testify in court, as needed, in matters regarding litigation related to their reviews.Prepares recommendations on preventive/corrective measures for the deterrent of future fraud.Supports other SIU investigators and analysts with their cases by providing clinical information/expertise and, as necessary, performs clinical reviews of medical records.Consults with external practitioners, medical professional groups and agencies, professional medical associations, the BlueCross BlueShield Association, the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and coordination with the BCBS Association National Anti-Fraud office, BC/BS Plan SIUs, FEP, CMS, DOH, OMIG, MFCU, local, state and federal law enforcement and prosecutorial agencies and medical licensing boards.Maintains accurate and up-to-date knowledge of all Government Programs regulations (Medicaid, Medicare, Federal Employee Program, New York State Department of Financial Services, etc.).Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.Ensures regular and reliable attendance.Performs other functions as assigned by management.Level II (in addition to Level I Accountabilities)Performs more complex investigations with less direct supervision. Performs compliance and/or governance on more complex special projects and audits.Offers process improvement suggestions and participates in the solution of more complex issues/activities.Provides and supports training or reference materials for internal team members as appropriate.Consistently provides accurate, organized and well written audit results with minimal assistance from management.Oversees and coordinates the daily activities of the non-clinical SIU staff medical record reviews.Keeps abreast of new developments in the field of medical technology through medical literature research, participation in seminars, monitoring professional society websites, etc.Mentors new/junior staff and assists with coaching, whenever necessary.Participates on committees.Level III (in addition to Level II Accountabilities)Manages the highest level of complex investigations, compliance and regulatory issues and exercises decision-making in project work groups.Assesses potential non-compliance vulnerabilities, identifies root causes of issues and provides practical business recommendations for corrections. Works with business area staff, Compliance, and other internal departments as necessary to develop recommendations and reach meaningful and appropriate resolutions.Serves as a subject matter expert and liaison for interdepartmental projects and represents non-clinical staff in discussions with Medical Directors and/or clinical consultants.Serves as an internal auditor/peer reviewer for new clinical staff, as needed.Mentors others in the department, provides coaching, guidance and leadership for daily activities of the SIU clinical staff, and acts as a resource to staff members.Provides backup for Supervisor/Manager, whenever necessary.Minimum QualificationsMust meet the NYS DFS’s and the NYS OMIG’s minimum investigator requirements: a minimum of five years in the healthcare field working in FWA investigations and audits; or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies; or seven years of professional investigation experience involving economic or insurance related matters; or an associate’s or bachelor’s degree in criminal justice or related field; or employment as an investigator in the SIU on or before December 28, 2022.Current NYS R.N. license with a minimum of three years clinical experience; medical/surgical background preferred.Current CPC designation or must obtain CPC designation within one year of hire date.Knowledge of medical record coding conventions (e.g. CPT, DRG, HCPCS, ICD10, etc.).A general understanding of contract benefits, electronic data processing systems, and organizational policies and procedures.Demonstrates excellent oral communication skills and proficient writing skills for the creation of comprehensive professional documents.Demonstrates proficient computer skills in Word, Excel, Internet, and email.Ability to multi-task and balance priorities.Excellent interpersonal skills.Level II (in Addition To Level I Qualifications)Two or more years of experience in the Medical Investigator role.Expertise in the technology of the job.Excellent understanding of contract benefits, electronic data processing systems, and corporate policies and procedures.Excellent ability to determine State and Federal fraudulent activity and compile necessary documentation for prosecution presentation. Ability to explain and interpret these findings to law enforcement authorities in a comprehensive manner.Excellent dispute resolution and negotiation skills to interface appropriately with many different provider types, attorneys, other Blue Plans and external agencies and business partners.Demonstrated superior oral communication skills, strong presentation skills, and strong writing skills for the creation of comprehensive professional documents.Proficient with health systems operations including an understanding of reimbursement methodologies and coding conventions for governmental and commercial products (e.g., Medicare, Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.).Extensive experience with claims processing systems, claims flow, adjudication process, system edits and display screens.Level III (in Addition To Level II Qualifications)Five or more years in a Medical Investigator role.Subject matter expert in health systems operations including an understanding of reimbursement methodologies and coding conventions for governmental and commercial products (e.g., Medicare, Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.).Comprehensive understanding of multiple functional areas (i.e., SIU, Legal, Regulatory, Operations) and supporting systems (breadth).Expertise in complex clinical coding/reviewing assignments, difficult investigations and highly visible issues (depth).Lead the training of new staff and provide feedback to management for evaluation.Displays leadership abilities and serves as a positive role model to others in the department.Demonstrates superior oral communication skills, excellent presentation skills and excellent writing skills for the creation of comprehensive professional documents.Physical RequirementsAbility to work prolonged periods sitting and/or standing at a workstation and working on a computer.Ability to travel across the Health Plan service region for meetings and/or trainings as needed.Compensation Range(s)Level I (E2): Minimum: $62,400 – Maximum: $96,081Level II (E4): Minimum: $65,346 – Maximum: $106,929Equal Opportunity EmployerAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.#J-18808-Ljbffr

Case Manager, RN or Licensed Behavioral Health (HARP)

Excellus BCBS East Syracuse, NY

Job DescriptionConducts 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 AccountabilitiesLevel IHandles behavioral health member clinical management programs.Maintains knowledge of current Case Management Society of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the activities as directed by departmental policy and leadership, current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable.Carries out job responsibilities in accordance with departmental, corporate, state, federal and accreditation standards, as well as licensure, certification and scope of practice requirements for each specific health‑related field/specialty.Maintains confidentiality and conducts information management procedures per corporate and departmental policy.Implements the Case Management Process per department policies, procedures and guidelines. The process includes case identification, case opening, member assessment, education and support intervention opportunities, developing care plans, conducting member‑centric interventions, measuring member outcomes during re‑assessment, case closure, and case reviews.Screens members that fall within the defined populations served, referred to the department, either by data analysis or by internal or external referral sources. Applies case management criteria and professional clinical judgment to determine a member’s appropriateness for case management services.Initiates case management, as outlined in the Case Management Program Description. Opens appropriate cases timely and effectively. Using motivational interviewing, assures essential information relating to case management is disclosed to members, thus increasing the opportunity for success in meeting member health goals.Works in collaboration with members’ physicians and other health care providers to assess the needs of the member, facilitate development of an interdisciplinary care plan, coordinates services, evaluates effectiveness of services and modifies the member care plan as necessary. Maintains positive working relationships within this arena.Assesses member/caregiver knowledge of his/her illness and initiates appropriate education interventions to address knowledge deficits.Collaborates with member/caregiver to determine specific objectives, goals and actions to address member needs and barriers to meeting health goals identified during assessment.Provides appropriate resources and assistance to members with regards to managing their health across the continuum of care. Maintains updated information related to appropriate community resources and serves as a source of information for providers and other members of the healthcare team. Acts as a liaison between providers and community resources.Participates in inter‑disciplinary coordination and collaboration to ensure delivery of consistent and quality health care services. Examples may include Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory Therapist.Accepts responsibility for continuing education relative to professional growth. Meets or exceeds the minimum continuing education requirements as set forth by departmental and corporate policy, and by individual professional certification standards, if applicable.Participates in and promotes other health plan programs, such as, Preventive Health, use of web‑based tools for self‑management of conditions and engagement in digital health programs and applications.Work collaboratively with all Case Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and coordination of care.May work with internal and external stakeholders for value‑based payment programs, such as accountable cost and quality arrangements (ACQA).Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.Regular and reliable attendance is expected and required.Performs other functions as assigned by management.Level II (in addition to Level I Accountabilities)Handles all member clinical condition management programs.Offers process improvement suggestions and participates in the solutions of more complex issues/activities.Mentors junior staff and assists with coaching whenever necessary.Consistently meets/exceeds all productivity and performance metrics, including positive results of audits.Works independently in coordinating and collaborating with members and providers, resulting in improving member and community health.Manages more complex assignments and/or larger caseloads.Displays leadership skills and serves as a positive role model to others in the department.Participates in the orientation of new staff.Level III (in addition to Level II Accountabilities)Process Management and Documentation – Identifies, recommends, and evaluates new processes as necessary to improve productivity and gain efficiencies.Assists in updating departmental policies, procedures and desk‑top manuals relative to the CM functions.Identifies and develops processes and guidelines for performance improvement opportunities for the Case Management Department.Expert and resource for escalations. Serves as subject matter expert and if called upon, works directly with the operation and clinical staff to resolve issues and escalated problems.Mentors and provides guidance and leadership to the daily activities of the Case Management Department clinical staff. Acts as resource to Case Management staff, members, and providers.Provides backup for the Supervisor/Manager, whenever necessary by: Participating in the orientation of new staff and/training opportunities for all staff. Assists staff to identify opportunities to successfully engage members into care.Acting as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit (SIU), Provider Relations (PR), or Sales & Marketing.Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group.Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational needs to address established policies and procedures and job responsibilities.Minimum QualificationsNOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.All LevelsActive NYS RN license required with three years’ behavioral health experience; or LMSW; or LCSW; or LMHC.Minimum of three years of clinical experience required. Case Management experience preferred.Must demonstrate proficiency with the Microsoft Office Suite.Experience in interpreting managed care benefit plans and strong knowledge of government program contracts (Medicare and Medicaid) and benefits, preferred.Strong written and verbal communication skills.Ability to multitask and balance priorities.Must demonstrate ability to work independently on a daily basis.Deliver efficient, effective, and seamless care to members.For incumbents aligned to the Federal Employee Program (FEP) line of business, Case Management Certification required within three (3) years of either hire and/or moving into this role supporting the FEP LOB.Level II (in addition to Level I Qualifications)A minimum of 2 years in case management position.Case Management Certification preferred.Delivers efficient, effective, and seamless care to members.Demonstrates ability to elevate to management, as necessary.Demonstrates proficiency in all related technology and documentation requirements.Consistently meets or exceeds all performance metrics.Level III (in addition to Level II Qualifications)Must have been in a current Case Management position or similar subject matter expert for at least 5 years.Case Management Certification required.Broad understanding of multiple areas (i.e. UM and CM). At this level, incumbent is required to know multiple functional areas and supporting systems.Expertise in Case Management area and able to handle complex assignments, challenging situations, and highly visible issues.Ability to lead the training of new staff.Demonstrated presentation skills.Physical RequirementsAbility to travel and work long hours on a computer.May require flexible hours to meet needs of member discussions.In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.Compensation Range(s)Level I:Minimum: $62,400 - Maximum: $96,081Level II:Minimum: $62,400 - Maximum: $106,929Level III:Minimum: $65,346 - Maximum: $117,622The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case‑by‑case basis.#J-18808-Ljbffr

Pharmacy Reimbursement Specialist

Kinney Drugs village of east syracuse, ny

Scope of Responsibilities Works under minimal supervision within Accounting and Finance department to ensure timely review of data for reporting to stores, outside Third-Party Business partners, as well as government agencies. Prepares reports and maintains various files and information for the department ensuring proper reimbursement. Job Summary Assists and supports the Accounting and Finance department in the achievement of Rx sales, gross margin according to plan. This is not a remote opportunity and will be in office only. Job Duties Responsible for reviewing, identifying and correcting billing issues based on contractual agreements. Responsible for PBM related billing communications regarding better reimbursement strategies and issues faced to all locations. Assist in auditing plans to verify contractual compliance. Responsible for monitoring MAC pricing and submitting MAC appeals daily and developing and maintaining MAC reporting and analysis. Responsible for using daily/weekly/monthly reports for Third Party billing and pricing accuracy to maintain the highest level of profitability. Working with the Pharmacy Business Analyst to develop reporting as needed to gain efficiencies and improve profitability. Responsible for monitoring and sending claims via the AWP resubmission tool and analysis reporting of outcomes. Responsible for reviewing, analyzing, and developing edits internally and through our switch that can improve efficiencies and/or profitability. Assist Third Party Administrator/ Reimbursement Supervisor with licensing, credentialing, and Third-Party training programs. Assist in the development and preparation of all claims related and profitability reporting. Responsible for resolving Third Party pharmacy questions received from Store Systems Help Desk. Responsible for yearly immunization configuration, reporting and analysis. Assist Third Party Administrator/Reimbursement Supervisor in the review of plan set up within the pharmacy application. Responsible for completing all mandatory and regulatory training programs. Perform other duties as assigned. Experience Preferred Previous experience in retail pharmacy, Third Party operations, and/or Finance/Accounting Educational Requirements Minimum: High School Diploma or GED Preferred: AS Degree or Higher in Business Administration, or related field Special Conditions of Employment Drug Test Initial and continuous exclusion and sanction/disciplinary monitoring Compensation $18.50 - $21.00 per hour The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education. KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements. #J-18808-Ljbffr

High salary

Pharmacy Reimbursement Specialist

KPH HEALTHCARE SERVICES, INC village of east syracuse, ny

Overview Works under minimal supervision within Accounting and Finance department to ensure timely review of data for reporting to stores, outside Third-Party Business partners, as well as government agencies. Prepares reports and maintains various files and information for the department ensuring proper reimbursement. Works collaboratively within the department to ensure licensing, credentialing and all necessary paperwork are in place for billing. This position is not a remote opportunity and will be in office only. Job Summary Assists and supports the Accounting and Finance department in the achievement of Rx sales, gross margin according to plan. Responsibilities Responsible for reviewing, identifying and correcting billing issues based on contractual agreements. Responsible for PBM related billing communications regarding better reimbursement strategies and issues faced to all locations. Assist in auditing plans to verify contractual compliance. Responsible for monitoring MAC pricing and submitting MAC appeals daily and developing and maintaining MAC reporting and analysis. Responsible for using daily/weekly/monthly reports for Third Party billing and pricing accuracy to maintain the highest level of profitability. Working with the Pharmacy Business Analyst to develop reporting as needed to gain efficiencies and improve profitability. Responsible for monitoring and sending claims via the AWP resubmission tool and analysis reporting of outcomes. Responsible for reviewing, analyzing, and developing edits internally and through our switch that can improve efficiencies and/or profitability. Assist Third Party Administrator/ Reimbursement Supervisor with licensing, credentialing, and Third-Party training programs. Assist in the development and preparation of all claims related and profitability reporting. Responsible for resolving Third Party pharmacy questions received from Store Systems Help Desk. Responsible for yearly immunization configuration, reporting and analysis. Assist Third Party Administrator/Reimbursement Supervisor in the review of plan set up within the pharmacy application. Responsible for completing all mandatory and regulatory training programs. Perform other duties as assigned. Qualifications Previous experience in retail pharmacy, Third Party operations, and/or Finance/Accounting Educational Requirements Minimum: High School Diploma or GED Preferred: AS Degree or Higher in Business Administration, or related field Special Conditions Of Employment Drug Test Initial and continuous exclusion and sanction/disciplinary monitoring Compensation $18.50 - $21.00 per hour. The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education. KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements. #J-18808-Ljbffr

Cash Review Clerk

KPH Healthcare Services East Syracuse, NY

Job TitleScope of Responsibilities: Works under minimal supervision and follows standard procedures to accomplish assigned tasks. May assist in orienting and training of new employees.Job Summary: Ensures the accurate and timely preparation of general ledger entries for the consolidation of the company financial statements. Performs daily functions for banking and cash management. Performs miscellaneous accounting duties.This role is on-site and in-person. Not a remote opportunity.ResponsibilitiesJob Duties:Audit sales report totals from the stores daily, verify accuracy and make correctionsPrepare a daily report of each stores bank account balance for reviewPrepare and properly post all miscellaneous administrative checks and deliver to bank dailyReconcile monthly bank statements for each store and administrationPrepare, enter and verify monthly ledger entries and distribute financial statements accordinglyBalance various general ledger accounts on a monthly basisFile cash-ups and cash-up bagsAssist in transferring funds between bank accounts on an as needed basisAssist with Western Union processes on an as needed basisAssist with auditor schedules at year endResearch and monitor store bank accounts for overdraftsResponsible for completing all mandatory and regulatory training programsPerform other duties as assignedQualificationsEducational Requirements:Required: High School Diploma or GEDPreferred: AS Degree or Higher in Accounting, Business Administration or related fieldExperience:Preferred: 3-4 Years or more of General Ledger/Accounting experiencePreferred: Basic knowledge of Microsoft Excel spreadsheetsSpecial Conditions of Employment:Drug testInitial and continuous exclusion and sanction/disciplinary monitoringAny and all additional eligibility requirements based on the specific positionCompensation: $19.00-20.00 per hourThe final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education.KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.

Part Time Last Mile Box Truck Delivery Driver Syracuse

Delaware Valley Floral Group East Syracuse, NY

Part Time Last Mile Box Truck Delivery Driver SyracuseEast Syracuse, NY - East Syracuse, NY 13057OverviewSalary Range $20.50 Hourly Position Type Part Time Job Shift 4AM Start Time Travel Percentage Road Warrior Category TransportationDescriptionCompany Overview:For over six decades, the Delaware Valley Floral Group (DVFG) has been at the forefront of providing professional retail florists, event designers and supermarkets across the nation with the highest quality of fresh cut flowers, greens, botanicals, and floral supplies. Established in 1959 as a modest family venture, the DVFG has flourished into one of the largest floral distribution companies in the United States.Our modern corporate headquarters, spanning over 100,000 square feet, is strategically situated in Sewell, New Jersey. Complementing this central hub are multiple satellite logistics, distribution and sales facilities located in key geographical regions, including Edison, NJ, Jessup, MD, Hauppauge, NY, Syracuse, NY, Hartford, CT, Wilkes-Barre, PA, Shrewsbury, MA, Pittsburgh, PA, Cleveland, OH, Richmond, VA, Miami, FL and Oxnard, CA.Our mission extends beyond just being a floral wholesaler to our customers; We Aspire To Be Their Most Valuable Supplier. Every member of our team plays a pivotal role in ensuring our customers receive the best possible products and services to help their business grow. We recognize that our employees are the cornerstone of our success as well, which is why we are committed to fostering a family-oriented culture where every individual's contributions are deeply valued and appreciated. Join us in shaping the future of floral distribution and become a part of our dynamic team here at the DVFG!Delaware Valley Floral Group is an equal-opportunity employer committed to hiring a diverse workforce at all levels, fostering a culture that enables us to better serve our customers, employees, and communities.Potential Quarterly Safety Incentive Bonus: Earn up to $1,500 per year.Position Overview:Delaware Valley Floral Group is currently seeking a Part time Delivery Driver to join our Syracuse Distribution Team. This is a part-time casual role responsible for operating a refrigerated box truck to deliver fresh floral products to flower shops throughout Syracuse, NY/Upstate NY area.Key Responsibilities:Safely operate a 16ft refrigerated box truck for daily deliveries.Ensure timely deliveries of fresh flowers and related products to customers.Maintain an organized and safe vehicle, ensuring cleanliness and proper functioning of equipment.Work efficiently in a warehouse and cooler environment (34F) utilizing equipment such as pallet jacks, box cutters, and RF scanners.Communicate effectively with clients, providing excellent customer service and fostering positive relationships.Follow assigned delivery routes using maps or GPS to optimize efficiency.Perform physical tasks, including loading, unloading, climbing in and out of the truck, driving, and handling products weighing up to 60 pounds.Ensure compliance with all company policies, safety standards, and DOT regulations.Schedule:Part-time, Monday through Friday (with occasional Saturdays required).Start time Monday through Friday at 4:00 AM until completion upon finishing the route.Physical Demands:Ability to stand, sit, walk, bend, kneel, and crouch for extended periods.Must be able to lift and move up to 60 pounds regularly.Vision requirements include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.Work Environment:Warehouse and cooler environment (34F).Utilization of equipment such as pallet jacks, box cutters, and RF Scanners for efficient handling and delivery of products.Proficiency in operating a 16ft Refrigerated Box truck is required.Qualifications2+ years of professional experience driving commercial vehicles (16ft box trucks or larger)Valid driver's license and ability to obtain DOT Medical Certification (CDL not required)Acceptable driving record (reviewed twice per year)Must be 21 or olderAble to lift up to 60 lbsStrong communication and customer service skillsComfortable using maps and GPS for route planningExcellent time management and multitasking abilitiesSelf-motivated with strong problem-solving skillsDependable, team-oriented, and hardworkingMust pass pre-employment screeningsIf you meet the above qualifications and are eager to join a growing, family-oriented company, we encourage you to apply and become part of the Delaware Valley Floral Group team!

Dynamic Environment

Medical Investigator I/II (RN Required)

Univera Healthcare East Syracuse, NY

SIU Medical InvestigatorUnder the guidance of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of business. The scope of accountability includes investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of care, interviewing potential witnesses, developing corrective action plans, developing correspondence to impacted parties, managing disputes, and collaborating with law enforcement and regulatory agencies.Essential Accountabilities:Functions as a clinical reviewer of medical records, researching and investigating complex medical cases. Interprets a variety of documents including, but not limited to provider contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding, inter-plan regulations, government policies, as well as diverse regulatory and legal requirements.Thoroughly researches allegations or issues and develops sources of information to create a plan of action, accumulates sufficient detailed evidence including statements, documents, records and exhibits. Evaluates situations accurately and interacts with management, medical directors and legal, where appropriate, to ensure complex issues are addressed appropriately.Prepares comprehensive summary reports and assures accuracy of information provided to providers, regulators, law enforcement, Legal, Compliance and outside counsel. Prepares cases for prosecution, civil settlement, or overpayment recoupment by documenting findings in a clear and concise manner.Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns.Manages cases as assigned, prioritizing case load as appropriate. Maintains case logs, prepares records and regular status reports. Interacts with health care providers, often under adverse conditions due to discovery of potential FWA. Discusses sensitive material in a professional, fair and accurate manner. Recommends providers for referrals to the New York State Office of Professional Medical Conduct/NYS Education Department, Office of Professional Discipline and/or internal referral for quality review by the applicable business area.Acts as primary point of contact with law enforcement for assigned cases and may be required to prepare files and testify in court, as needed, in matters regarding litigation related to their reviews.Prepares recommendations on preventive/corrective measures for the deterrent of future fraud.Supports other SIU investigators and analysts with their cases by providing clinical information/expertise and as necessary, performs clinical reviews of medical records.Consults with external practitioners, medical professional groups and agencies, professional medical associations, the BlueCross BlueShield Association, the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and coordination with the BCBS Association National Anti-Fraud office, BC/BS Plan SIUs, FEP, CMS, DOH, OMIG, MFCU, local, state and federal law enforcement and prosecutorial agencies and medical licensing boards.Maintains accurate and up-to-date knowledge of all Government Programs regulations (Medicaid, Medicare, Federal Employee Program, New York State Department of Financial Services, etc.).Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.Regular and reliable attendance is expected and required.Performs other functions as assigned by management.Level II (in addition to Level I Accountabilities)Performs more complex investigations with less direct supervision. Performs compliance and/or governance on more complex special projects and audits.Offers process improvement suggestions and participates in the solution of more complex issues/activities.Provides and supports training or reference materials for internal team members as appropriate.Consistently provides accurate, organized and well written audit results with minimal assistance from management.Oversees and coordinates the daily activities of the non-clinical SIU staff medical record reviews.Keeps abreast of new developments in the field of medical technology through medical literature research, participation in seminars, monitoring professional society websites, etc.Mentors new/junior staff and assists with coaching, whenever necessary.Participates on committees.Level III (in addition to Level II Accountabilities)Manages the highest level of complex investigations, compliance and regulatory issues and exercises decision-making in project work groups.Assesses potential non-compliance vulnerabilities, identifies root causes of issues and provides practical business recommendations for corrections. Works with business area staff, Compliance, and other internal departments as necessary to develop recommendations and reach meaningful and appropriate resolutions.Serves as a subject matter expert and liaison for interdepartmental projects and represents non-clinical staff in discussions with Medical Directors and/or clinical consultants.Serves as an internal auditor/peer reviewer for new clinical staff, as needed.Mentors (to others in the department), provides coaching, guidance and leadership for daily activities of the SIU clinical staff. Acts as a resource to staff members.Provides back-up for Supervisor/Manager, whenever necessary.Minimum Qualifications:Must meet the NYS DFS's and the NYS OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall include: A minimum of five years in the healthcare field working in FWA investigations and audits; or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies; or seven years of professional investigation experience involving economic or insurance related matters; or an associate's or bachelor's degree in criminal justice or related field; or employment as an investigator in the SIU on or before December 28, 2022.Current NYS R.N. license with a minimum of three years clinical experience; medical/surgical background preferred.Current CPC designation or must obtain CPC designation within one year of hire date.Knowledge of medical record coding conventions (e.g. CPT, DRG, HCPCS, ICD10, etc.).A general understanding of contract benefits, electronic data processing systems, and organizational policies and procedures.Demonstrates excellent oral communication skills and proficient writing skills for the creation of comprehensive professional documents.Demonstrates proficient computer skills in Word, Excel, Internet, and email.Ability to multi-task and balance priorities.Excellent interpersonal skills.Level II (in addition to Level I Qualifications)Two or more years of experience in the Medical Investigator role.Expertise in the technology of the job.Excellent understanding of contract benefits, electronic data processing systems, and corporate policies and procedures.Excellent ability to determine State and Federal fraudulent activity and compile necessary documentation for prosecution presentation. Ability to explain and interpret these findings to law enforcement authorities in a comprehensive manner.Excellent dispute resolution and negotiation skills in order to interface appropriately with many different provider types, attorneys, other Blue Plans and external agencies and business partners.Demonstrated superior oral communication skills, strong presentation skills, and strong writing skills for the creation of comprehensive professional documents.Proficient with health systems operations including an understanding of reimbursement methodologies and coding conventions for governmental and commercial products (e.g., Medicare, Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.).Extensive experience with claims processing systems, claims flow, adjudication process, system edits and display screens.Level III (in addition to Level II Qualifications)Five or more years in a Medical Investigator role.Subject matter expert in health systems operations including an understanding of reimbursement methodologies and coding conventions for governmental and commercial products (e.g., Medicare, Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.).Comprehensive understanding of multiple functional areas (i.e., SIU, Legal, Regulatory, Operations) and supporting systems. (BREADTH).Expertise in complex clinical coding/reviewing assignments, difficult investigations and highly visible issues. (DEPTH).Lead the training of new staff and provide feedback to management for evaluation.

Part Time Last Mile Box Truck Delivery Driver Syracuse

Delaware Valley Floral Group East Syracuse, NY

High salary

Case Manager, RN (Multiple Openings!)

Excellus Health Plan East Syracuse, NY

Case Management Program ActivitiesConducts 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 Accountabilities:Handles physical health member clinical management programs.Maintains knowledge of current Case Management Society Of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the activities as directed by departmental policy and leadership, current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable.Carries out job responsibilities in accordance with departmental, corporate, state, federal and accreditation standards, as well as licensure, certification and scope of practice requirements for each specific health-related field/specialty,Maintains confidentiality and conducts information management procedures per corporate and departmental policy.Implements the Case Management Process per department policies, procedures and guidelines. The process includes case identification, case opening, member assessment, education and support intervention opportunities, developing care plans, conducting member-centric interventions, measuring member outcomes during re-assessment, case closure, and case reviews.Screens members that fall within the defined populations served, referred to the department, either by data analysis or by internal or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management services.Initiates case management, as outlined in the Case Management Program Description. Opens appropriate cases timely and effectively. Using motivational interviewing, assures essential information relating to case management is disclosed to members, thus increasing the opportunity for success in meeting member health goals.Works in collaboration with members' physicians and other health care providers to assess the needs of the member, facilitate development of an interdisciplinary care plan, coordinates services, evaluates effectiveness of services and modifies the member care plan as necessary. Maintains positive working relationships within this arena.Assesses member/caregiver knowledge of his/her illness and initiates appropriate education interventions to address knowledge deficits.Collaborates with member/caregiver to determine specific objectives, goals and actions to address member needs and barriers to meeting health goals identified during assessment.Provides appropriate resources and assistance to members with regards to managing their health across the continuum of care. Maintains updated information related to appropriate community resources and serves as a source of information for providers and other members of the healthcare team. Acts as a liaison between providers and community resources.Participates in inter-disciplinary coordination and collaboration to ensure delivery of consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory TherapistAccepts responsibility for continuing education relative to professional growth. Meets or exceeds the minimum continuing education requirements as set forth by departmental and corporate policy, and by individual professional certification standards, if applicable.Participates in and promotes other health plan programs, such as, Preventive Health, use of web-based tools for self-management of conditions and engagement in digital health programs and applications.Work collaboratively with all Case Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and coordination of care.May work with internal and external stakeholders for value-based payment programs, such as accountable cost and quality arrangements (ACQA).Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code Of Conduct, and leading to the Lifetime Way values and beliefs.Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.May participate in the orientation of new staff.Regular and reliable attendance is expected and required.Performs other functions as assigned by management.Level II (in addition to Level I Essential Accountabilities)Handles all member clinical condition management programs.Offers process improvement suggestions and participates in the solutions of more complex issues/activities.Mentors junior staff and assists with coaching whenever necessary.Consistently meets/exceeds all productivity and performance metrics, including positive results of audits.Works independently in coordinating and collaborating with members and providers, resulting in improving member and community health.Manages more complex assignments and/or larger caseloads.Displays leadership skills and serves as a positive role model to others in the department.Participates in the orientation of new staff.Level III (in addition to Level II Essential Accountabilities)Process Management and Documentation Identifies, recommends, and evaluates new processes as necessary to improve productivity and gain efficiencies.Assists in updating departmental policies, procedures and desk-top manuals relative to the CM functions.Identifies and develops processes and guidelines for performance improvement opportunities for the Case Management Department.Expert and resource for escalations. Serves as subject matter expert and if called upon, works directly with the operation and clinical staff to resolve issues and escalated problems.Mentors and provides guidance and leadership to the daily activities of the Case Management Department clinical staff. Acts as resource to Case Management staff, members, and providers.Provides backup for the Supervisor/Manager, whenever necessary by: Participating in the orientation of new staff and/training opportunities for all staff. Assists staff to identify opportunities to successfully engage members into care.Acting as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit (SIU), Provider Relations (PR), or Sales & Marketing.Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group.Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational needs to address established policies and procedures and job responsibilities.Minimum Qualifications:Associates degree required. Bachelor's degree preferred.Active NYS RN or Registered Dietician or Physical Therapist licensure required.Minimum of three years of clinical experience required. Case Management experience preferred.Must demonstrate proficiency with the Microsoft Office Suite.Experience in interpreting managed care benefit plans and strong knowledge of government program contracts (Medicare and Medicaid) and benefits, preferred.Strong written and verbal communication skills.Ability to multitask and balance priorities.Must demonstrate ability to work independently on a daily basis.Deliver efficient, effective, and seamless care to members.For incumbents aligned to the Federal Employee Program (FEP) line of business, Case Management Certification required within two (2) years of either hire and/or moving into this role supporting the FEP LOB.Level II (in addition to Level I Qualifications)A minimum of 2 years in case management position.Case Management Certification preferred.Delivers efficient, effective, and seamless care to members.Demonstrates ability to escalate to management, as necessary.Demonstrates proficiency in all related technology and documentation requirements.Consistently meets or exceeds all performance metrics.Level III (in addition to Level II Qualifications)Must have been in a current Case Management position or similar subject matter expert for at least 5 years.

Case Manager, RN or Licensed Behavioral Health (HARP)

Excellus Health Plan East Syracuse, NY

Case Management Program CoordinatorConducts 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 Accountabilities: Handles behavioral health member clinical management programs. Maintains knowledge of current Case Management Society of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the activities as directed by departmental policy and leadership, current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. Carries out job responsibilities in accordance with departmental, corporate, state, federal and accreditation standards, as well as licensure, certification and scope of practice requirements for each specific health-related field/specialty, Maintains confidentiality and conducts information management procedures per corporate and departmental policy. Implements the Case Management Process per department policies, procedures and guidelines. The process includes case identification, case opening, member assessment, education and support intervention opportunities, developing care plans, conducting member-centric interventions, measuring member outcomes during re-assessment, case closure, and case reviews. Screens members that fall within the defined populations served, referred to the department, either by data analysis or by internal or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management services. Initiates case management, as outlined in the Case Management Program Description. Opens appropriate cases timely and effectively. Using motivational interviewing, assures essential information relating to case management is disclosed to members, thus increasing the opportunity for success in meeting member health goals. Works in collaboration with members' physicians and other health care providers to assess the needs of the member, facilitate development of an interdisciplinary care plan, coordinates services, evaluates effectiveness of services and modifies the member care plan as necessary. Maintains positive working relationships within this arena. Assesses member/caregiver knowledge of his/her illness and initiates appropriate education interventions to address knowledge deficits. Collaborates with member/caregiver to determine specific objectives, goals and actions to address member needs and barriers to meeting health goals identified during assessment. Provides appropriate resources and assistance to members with regards to managing their health across the continuum of care. Maintains updated information related to appropriate community resources and serves as a source of information for providers and other members of the healthcare team. Acts as a liaison between providers and community resources. Participates in inter-disciplinary coordination and collaboration to ensure delivery of consistent and quality health care services. Examples may include Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory Therapist Accepts responsibility for continuing education relative to professional growth. Meets or exceeds the minimum continuing education requirements as set forth by departmental and corporate policy, and by individual professional certification standards, if applicable. Participates in and promotes other health plan programs, such as, Preventive Health, use of web-based tools for self-management of conditions and engagement in digital health programs and applications. Work collaboratively with all Case Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and coordination of care. May work with internal and external stakeholders for value-based payment programs, such as accountable cost and quality arrangements (ACQA). Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management.Level II (in addition to Level I Accountabilities) Handles all member clinical condition management programs. Offers process improvement suggestions and participates in the solutions of more complex issues/activities. Mentors junior staff and assists with coaching whenever necessary. Consistently meets/exceeds all productivity and performance metrics, including positive results of audits. Works independently in coordinating and collaborating with members and providers, resulting in improving member and community health. Manages more complex assignments and/or larger caseloads. Displays leadership skills and serves as a positive role model to others in the department. Participates in the orientation of new staff.Level III (in addition to Level II Accountabilities): Process Management and Documentation o Identifies, recommends, and evaluates new processes as necessary to improve productivity and gain efficiencies.o Assists in updating departmental policies, procedures and desk-top manuals relative to the CM functions.o Identifies and develops processes and guidelines for performance improvement opportunities for the Case Management Department. Expert and resource for escalations. Serves as subject matter expert and if called upon, works directly with the operation and clinical staff to resolve issues and escalated problems. Mentors and provides guidance and leadership to the daily activities of the Case Management Department clinical staff. Acts as resource to Case Management staff, members, and providers. Provides backup for the Supervisor/Manager, whenever necessary by:o Participating in the orientation of new staff and/training opportunities for all staff. Assists staff to identify opportunities to successfully engage members into care.o Acting as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit (SIU), Provider Relations (PR), or Sales & Marketing.o Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational needs to address established policies and procedures and job responsibilities.Minimum Qualifications:NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.All Levels Active NYS RN license required with three years' behavioral health experience; or LMSW; or LCSW; or LMHC. Minimum of three years of clinical experience required. Case Management experience preferred. Must demonstrate proficiency with the Microsoft Office Suite. Experience in interpreting managed care benefit plans and strong knowledge of government program contracts (Medicare and Medicaid) and benefits, preferred. Strong written and verbal communication skills. Ability to multitask and balance priorities. Must demonstrate ability to work independently on a daily basis. Deliver efficient, effective, and seamless care to members.For incumbents aligned to the Federal Employee Program (FEP) line of business, Case Management Certification required within three (3) years of either hire and/or moving into this role supporting the FEP LOB.Level II (in addition to Level I Qualifications) A minimum of 2 years in case management position. Case Management Certification preferred Delivers efficient, effective, and seamless care to members. Demonstrates ability to escalate to management, as necessary. Demonstrates proficiency in all related technology and documentation requirements. Consistently meets or exceeds all performance metrics.Level III (in addition to Level II Qualifications) Must have been in a current Case Management position or similar subject matter expert for at least 5 years. Case Management Certification required Broad understanding of multiple areas (i.e. UM and CM

Best Match

ERP Data Strategy Engineer

INFICON East Syracuse, NY

Job DescriptionJob DescriptionCompany DescriptionINFICON is a leading provider of innovative instrumentation, critical sensor technologies, and Smart Manufacturing/Industry 4.0 software solutions that enhance productivity and quality of tools, processes, and complete factories. These analysis, measurement and control products are essential for gas leak detection in air conditioning/refrigeration and automotive manufacturing. They are vital to equipment manufacturers and end-users in the complex fabrication of semiconductors and thin film coatings for optics, flat panel displays, solar cells and industrial vacuum coating applications. Other users of our vacuum-based processes include the life sciences, research, aerospace, packaging, heat treatment, laser cutting and many other industrial processes. We also leverage our expertise in vacuum technology to provide unique, toxic chemical analysis products for emergency response, security, and environmental health and safety.Job DescriptionThe ERP Data Strategy Engineer is responsible for leading the existing ERP Data Specialist team in solving problems related to existing SAP manufacturing data setup and providing technical guidance related to SAP best practices. This individual will also play a key role on INFICON's SAP 4/HANA transformation team and will be responsible for assessing, analyzing and validating the manufacturing data for the America region. This role will also help to lead major SAP and other associated manufacturing software-related improvement initiatives. This individual will need to be a detail-orientated individual who has a proven track record of problem solving and a resourceful mentality. Essential Job Duties Specific duties include, but are not necessarily limited to the following: Provide trouble-shooting and technical guidance to the ERP Data Specialists on SAP and other related issues they encounter during engineering change implementation and production-floor related issues Perform root-cause/corrective investigations on SAP related issues on the production-floor related to items such as inventory discrepancies, material allocations, cost-variances & work-instruction discrepancies Work as a major member on INFICON’s SAP 4/HANA implementation team – this is expected to take a minimum of 50% of the individuals time for the duration of the project and the individual will report in a dotted-line manner to the 4/HANA Data Governance Project team lead. The work on this project will consist of items such as the following: Support data integrity and process alignment within SAP as part of the S/4HANA transformation Collaborate with the global governance team to develop documentation & maintenance strategies for master data responsibilities along with any associated business processes Assist in data migration activities by analyzing current-state data, performing data uploads & validations along with any associated troubleshooting and assessment of overall plant readiness Support training efforts to help end-users understand processes, impacts and relevant data prior to implementation/go-live Up to 10% travel for the project role duration (2026 to 2028) Act as the technical project lead in the implementation of the full functionality across the organization of the SAP Engineering Change workflow process Develop and maintain template files, best-practice guides & other ERP related items that improve standardization and overall data integrity practices within the team Act as the intermediary between the ERP Data Specialist team and INFICON’s Global SAP team and become the regional Subject Matter Expert (SME) on SAP manufacturing related topics Provide guidance on data-structure and best-practices and ways of working as INFICON begins the roll-out and usage of a new Manufacturing Execution Software (MES) solution Work to recommend and implement standardizations on production floor digitization-related items such as bar-code, serialization & associated software tools Work to ensure both internal & external customers are satisfied with the team’s response in dealing with the inevitable SAP and other associated manufacturing data related issues that arise in a manufacturing organization Work jointly on a near-daily basis with INFICON’s production & Global SAP teams QualificationsEducation and/or Experience Demonstrated experience as a power-user of an ERP system(s) and deep familiarity with Engineering Changes, BOMs, routings & production work orders, preferably in a low-volume, high-mix manufacturing organization with customer-configurable product offerings Minimal requirement Bachelor’s Degree in a technical discipline and 5+ years of experience or the equivalent combination of education, training & experience Experience with SAP is strongly preferred – experience with similar ERP systems is acceptable provided the individual has a demonstrated ability of being strong at self-education on software systems/capabilities Demonstrated ability to develop methods of entry/edits of large ERP datasets Preferred experience generating data queries to investigate and make data edits/loads on a large-scale basis Behaviors necessary for this role include, but are not necessarily limited to: Detail-orientated and analytically focused individual who has a proven track record of problem solving and a resourceful mentality Individual who enjoys challenges and can articulate their thoughts and ideas clearly & effectively Independent and driven individual who is good at collaborating with others on projects and technical initiatives The ability to manage multiple projects at the same time Establish credibility & trust from all levels of the organization Additional InformationA reasonable estimate of the current range is: $85,000 to $110,000. The actual compensation will be determined based on experience, location, and other factors permitted by law. In addition, INFICON employees are eligible for a profit-sharing bonus with a target of 10% as well as 401K match up to 8% (vesting schedule).INFICON provides a dynamic work environment that promotes diversity, equity, and inclusion. Our employees experience ongoing green initiatives, flexible work hours, and a variety of health and wellness programs.INFICON’s forward-thinking approach offers countless opportunities to design, support, and manufacture a diverse product portfolio that expands globally. Our Lean and Agile work environment offers competitive compensation, relocation assistance, a discretionary bonus, and generous employee benefits; major medical, dental, health, vision, 401K, vacation and sick time, tuition reimbursement, and more!INFICON is committed to ensuring that our online application process provides an equal opportunity to all job seekers that apply without regard to race, religion, ethnicity, national origin, citizenship, gender, age, protected veteran status, disability status, genetic information, sexual orientation, or any other protected characteristic. A notice describing Federal equal employment opportunity laws is available here to reaffirm this commitment. Any contact that would like to request a reasonable accommodation to participate in the application process should contact [email protected], Inc. strictly complies with all aspects of the Export Administration Regulations ('EAR'), including those sections dealing with deemed exports to foreign nationals.

Digital Content Creator Summer Intern

INFICON East Syracuse, NY

Job DescriptionJob DescriptionCompany DescriptionINFICON is a leading provider of innovative instrumentation, critical sensor technologies, and Smart Manufacturing/Industry 4.0 software solutions that enhance productivity and quality of tools, processes, and complete factories. These analysis, measurement and control products are essential for gas leak detection in air conditioning/refrigeration and automotive manufacturing. They are vital to equipment manufacturers and end-users in the complex fabrication of semiconductors and thin film coatings for optics, flat panel displays, solar cells and industrial vacuum coating applications. Other users of our vacuum-based processes include the life sciences, research, aerospace, packaging, heat treatment, laser cutting and many other industrial processes. We also leverage our expertise in vacuum technology to provide unique, toxic chemical analysis products for emergency response, security, and environmental health and safety.Job DescriptionWe’re looking for a creative digital storyteller to help bring our people, technology, and culture to life through video and digital content.As part of the INFICON Americas Marketing Communications team, you’ll play a hands-on role in creating content that supports both customers and talent recruitment. This internship is designed for someone who is curious, creative, and excited to translate complex ideas into engaging, authentic, human-centered stories.You’ll work directly with the Marketing Communications Manager and collaborate with teams across the business to create content in key areas:Culture and RecruitmentR&D and InnovationProduct and ServiceYou will also support video optimization and content ideation.Specific duties include, but are not necessarily limited to:Help plan, and independently shoot, and edit short-form video content for use across social media, YouTube, and internal channelsPartner with engineers, researchers, product managers, and service teams (among others) to capture content and translate technical concepts into clear, engaging storiesConduct informal interviews with employees to highlight culture, career paths, and day-to-day workAssist in scripting, storyboarding, and organizing video shootsEdit video using tools such as Adobe Premiere Pro, CapCut, or similar platforms; incorporate captions, graphics, music, voiceover, and branding elementsAudit existing YouTube content and improve titles, descriptions, tags, and thumbnails to increase visibility (SEO)Organize and maintain a library of raw footage and finalized assets for future useParticipate in content planning sessions and contribute new ideas for video concepts and formatsSupport light copywriting for video descriptions, captions, and social media postsTake product photos as needed or proactively to help build a library for use on social media or websiteSupport artwork/file archiving and organizationQualificationsActive student with two or more years of marketing, communications, digital media, or relevant course work Demonstrated ability in video storytelling (portfolio required)Experience shooting video (iPhone is fine)Working knowledge of Adobe Premiere Pro, CapCut, or similar platformStrong interpersonal skills and comfort working with a variety of teamsCurious and proactive; willing to ask questions and take initiativeBasic understanding (or willingness to learn) video SEO, YouTube optimization, and content performance metricsStrong attention to detail, organization, and ability to manage multiple tasksSelf-motivated with a positive attitude and enthusiasm for learningAbility to work independently with guidance from mentorMust be proficient with social media platforms and Microsoft Office applicationsAdditional InformationFor New York, the expected salary range for this position is between $18.00-$26.00 per hour. The actual compensation will be determined based on experience, location, and other factors permitted by law.INFICON provides a dynamic work environment that promotes diversity, equity, and inclusion. Our employees experience ongoing green initiatives, flexible work hours, and a variety of health and wellness programs.Explore abundant growth opportunities and enhance your skill set with INFICON's innovative mindset. Join our dynamic work atmosphere, which features competitive compensation, potential relocation support, and extra perks such as comprehensive medical coverage, sick time, and more!Selected candidates must have reliable transportation, as our facility is not conveniently located near a bus route. INFICON is committed to ensuring that our online application process provides an equal opportunity to all job seekers that apply without regard to race, religion, ethnicity, national origin, citizenship, gender, age, protected veteran status, disability status, genetic information, sexual orientation, or any other protected characteristic. A notice describing Federal equal employment opportunity laws is available here to reaffirm this commitment. Any contact that would like to request a reasonable accommodation to participate in the application process should contact [email protected], Inc. strictly complies with all aspects of the Export Administration Regulations ('EAR'), including those sections dealing with deemed exports to foreign nationals.

CNC Machinist I

Armstrong Rapid Manufacturing East Syracuse, NY

Job DescriptionJob DescriptionArmstrong has an opening for a first shift CNC Machinist 1. Armstrong Rapid manufacturing has been in business for over 50 years in the East Syracuse NY area. Armstrong specializes in both prototyped and low volume production machined castings. Armstrong has a benefit package that includes paid holidays, bonus and referral programs, paid vacation, a 401K, 100% company paid life insurance, sick time, supplemental short term disability insurance, dental, medical, vision, accident, cancer and critical care insurance plus safety awards. We also provide free coffee daily for our employees available at multiple coffee kiosks. Our website is www.armstrongrm.com and it shows many of the exciting aspects of our company! Take a look!The salary range for our CNC Machinist 1 job is $27.00-$36.00 per hour with the job description below. Summary/Objective: Responsible for producing precision-machined components by setting up and operating horizontal or vertical CNC (Computer Numerical Control) machining centers. Ensures strict adherence to quality, documentation, and safety standards. Must possess the ability to optimize machining processes for enhanced efficiency and precision.Job ResponsibilitiesInterpret blueprints and work instructions to set up and operate 3 & 4-axis CNC mills with the correct fixturing, tooling and parameters to produce compliant precision machined parts.Verify machined part accuracy through precision measuring tools and equipment using the documented quality plan.Troubleshoot machining issues and make real-time adjustments to improve performance and accuracy.Train and mentor junior machinists, sharing knowledge and best practices.Maintain detailed production records and comply with quality assurance and safety protocols.Perform routine maintenance and troubleshooting on machines to prevent downtime.Maintains equipment by completing preventive maintenance requirements; following manufacturer's instructions; troubleshooting malfunctions; calling for repairs.Maintains continuity among work shifts by documenting and communicating actions, irregularities, and continuing needs.Adheres to all safety policies and procedures, consistently uses personal protective equipment and practices good housekeepingMaintains regular on time attendance and adheres to company policies, procedures, and standards of conduct. Performs other tasks as directed. Educational, Experience Based, and Skill QualificationsMinimum of 7 years CNC machining experience in set-up, operation, and optimizing CNC vertical and horizontal machine centersStrong understanding of CNC machining and programming principlesAbility to edit and or write basic machining macrosAbility to quickly identify and troubleshoot machining problems during the approval or production processAbility to read and interpret blueprints with a solid understanding of Geometric Dimensioning and Tolerancing (GD&T)Strong attention to detail.High school diploma or equivalentPhysical RequirementsAbility to walk, remain on feet for extended time periods, reach, stoop. Kneel and lift up to an including 35 pounds as needed.AAP/EEO Statement Armstrong Mold Corporation is committed to equal opportunity, to providing a work environment that is free from unlawful discrimination and will not discriminate with regard to race, religion, color, national origin, sex, age, veteran status, disability, genetic information, or any other protected status. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, veteran status, disability, genetic information, or any other protected status. Armstrong Mold Corporation is proud to be an Equal Opportunity Employer (EOE). Armstrong Mold Corporation will make reasonable accommodation(s) for qualified applicants with disabilities and employees* If you are interested in applying for employment and feel you need a reasonable accommodation to apply for a posted position, or are an employee with a question contact Human Resources at 315-437-1517 or by email to [email protected].* unless an employee reasonable accommodation would result in undue hardship.Management reserves the right to revise job description(s) at any time. This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of this job. Duties, responsibilities and activities may change at any time with or without notice.Job Posted by ApplicantPro

CNC Machinist I

Armstrong Rapid Manufacturing East Syracuse, NY

Job DescriptionJob DescriptionArmstrong has an opening for a first shift CNC Machinist 1. Armstrong Rapid manufacturing has been in business for over 50 years in the East Syracuse NY area. Armstrong specializes in both prototyped and low volume production machined castings. Armstrong has a benefit package that includes paid holidays, bonus and referral programs, paid vacation, a 401K, 100% company paid life insurance, sick time, supplemental short term disability insurance, dental, medical, vision, accident, cancer and critical care insurance plus safety awards. We also provide free coffee daily for our employees available at multiple coffee kiosks. Our website is www.armstrongrm.com and it shows many of the exciting aspects of our company! Take a look!The salary range for our CNC Machinist 1 job is $27.00-$33.00 per hour with the job description below. Summary/Objective: Responsible for producing precision-machined components by setting up and operating horizontal or vertical CNC (Computer Numerical Control) machining centers. Ensures strict adherence to quality, documentation, and safety standards. Must possess the ability to optimize machining processes for enhanced efficiency and precision.Job ResponsibilitiesInterpret blueprints and work instructions to set up and operate 3 & 4-axis CNC mills with the correct fixturing, tooling and parameters to produce compliant precision machined parts.Verify machined part accuracy through precision measuring tools and equipment using the documented quality plan.Troubleshoot machining issues and make real-time adjustments to improve performance and accuracy.Train and mentor junior machinists, sharing knowledge and best practices.Maintain detailed production records and comply with quality assurance and safety protocols.Perform routine maintenance and troubleshooting on machines to prevent downtime.Maintains equipment by completing preventive maintenance requirements; following manufacturer's instructions; troubleshooting malfunctions; calling for repairs.Maintains continuity among work shifts by documenting and communicating actions, irregularities, and continuing needs.Adheres to all safety policies and procedures, consistently uses personal protective equipment and practices good housekeepingMaintains regular on time attendance and adheres to company policies, procedures, and standards of conduct. Performs other tasks as directed. Educational, Experience Based, and Skill QualificationsMinimum of 7 years CNC machining experience in set-up, operation, and optimizing CNC vertical and horizontal machine centersStrong understanding of CNC machining and programming principlesAbility to edit and or write basic machining macrosAbility to quickly identify and troubleshoot machining problems during the approval or production processAbility to read and interpret blueprints with a solid understanding of Geometric Dimensioning and Tolerancing (GD&T)Strong attention to detail.High school diploma or equivalentPhysical RequirementsAbility to walk, remain on feet for extended time periods, reach, stoop. Kneel and lift up to an including 35 pounds as needed.AAP/EEO Statement Armstrong Mold Corporation is committed to equal opportunity, to providing a work environment that is free from unlawful discrimination and will not discriminate with regard to race, religion, color, national origin, sex, age, veteran status, disability, genetic information, or any other protected status. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, veteran status, disability, genetic information, or any other protected status. Armstrong Mold Corporation is proud to be an Equal Opportunity Employer (EOE). Armstrong Mold Corporation will make reasonable accommodation(s) for qualified applicants with disabilities and employees* If you are interested in applying for employment and feel you need a reasonable accommodation to apply for a posted position, or are an employee with a question contact Human Resources at 315-437-1517 or by email to [email protected].* unless an employee reasonable accommodation would result in undue hardship.Management reserves the right to revise job description(s) at any time. This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of this job. Duties, responsibilities and activities may change at any time with or without notice.Job Posted by ApplicantPro

Human Resources Business Partner

Pinnacle Employee Services LLC East Syracuse, NY

Job DescriptionJob DescriptionHuman Resources Business PartnerPosition SummaryThe HR Business Partner serves as the primary point of contact between Pinnacle Employee Services (PES), client companies, and their Worksite Employees (WSEs). This role is responsible for supporting day-to-day client and employee needs by responding to inbound calls and emails and ensuring the effective delivery of PES services across payroll, benefits, and human resources. The HR Business Partner plays a key role in maintaining strong client relationships, resolving service-related issues, identifying opportunities for improvement, and escalating complex matters to specialized PES resources when necessary. A successful HR Business Partner delivers accurate, timely, and empathetic support while promoting a positive client and employee experience. Essential Duties and ResponsibilitiesIndependently resolve general WSE inquiries related to payroll, benefits, and human resources. Provide accurate information with a sense of urgency while maintaining a friendly, professional, and empathetic approach. Strive to achieve first-contact resolution whenever possible. Ensure proper triage and escalation of complex or sensitive issues to appropriate Subject Matter Experts. Build and maintain effective working relationships with internal departments and client company representatives. Unemployment & Compliance SupportComplete unemployment claims accurately and in a timely manner, acting in the best interest of client companies. Attend unemployment hearings on behalf of client companies as required. Interpret payroll and HR policies and provide guidance to clients and WSEs. Maintain knowledge of federal, state, and out-of-state employment regulations. Confirm posting of required state and federal labor law posters at client locations. Human Resources & TrainingDevelop, maintain, and update employee handbooks and handbook policies for client companies. Coordinate and administer sexual harassment prevention and workplace harassment training for WSEs. Conduct sexual harassment and workplace investigations in collaboration with client companies and WSEs. Coordinate additional training requests for WSEs as reasonably requested by client companies. Benefits, Payroll & Workers’ CompensationAssist client companies with workers’ compensation documentation for WSEs on leave due to work-related injuries. Report workers’ compensation claims for clients enrolled under the Master Workers’ Compensation policy. Demonstrate strong knowledge of benefit offerings and respond to benefit-related inquiries accurately. Reprint and distribute payroll documents such as pay stubs, W-2s, and other requested records for current and former WSEs. Client Engagement & OperationsConduct a minimum of five client touchpoints per week through virtual or in-person meetings. Deliver requested supplies and forms to client companies (applications, pay rate forms, tax documents, etc.). Create and edit Excel spreadsheets as requested by client companies. Support the implementation of new policies and procedures with both clients and WSEs. Learn and effectively utilize the HRIS system (PRISM). Attend conferences and professional development opportunities to remain current on HR best practices. Perform additional duties and projects as assigned by management. Job Requirements and QualificationsEducationHigh school diploma or equivalent required; an equivalent combination of education and experience will be considered. SHRM-CP, SHRM-SCP, PHR, or other HR certifications are a plus. ExperienceMinimum of 2 years of experience in Human Resources and/or Customer Service. Experience with HR systems and automated operating environments preferred. Experience in an HR Outsourcing or PEO environment is a plus. Knowledge, Skills, and AbilitiesProficiency in Microsoft Office applications, including strong Excel skills. Ability to navigate HRIS systems and quickly learn new software and tools. Strong attention to detail and organizational skills. Excellent customer service, communication, and problem-solving abilities. Strong interpersonal skills with the ability to collaborate effectively across teams. Excellent written and verbal communication skills. Ability to utilize intranets, extranets, and internet-based business applications. Ability to take ownership of client needs and maintain a high level of customer satisfaction. Ability to remain professional and effective in a changing, fast-paced environment. Ability to manage multiple priorities and meet deadlines in a team-oriented setting.