- Molina Healthcare (Rochester, NY)
- … Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification. To ... to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based...to assist Molina Healthcare members with their healthcare needs. Care Management staff work to… more
- Molina Healthcare (Albany, NY)
- …Utilization Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification. ... prior authorizations, inpatient/outpatient medical necessity/utilization review, and/or other utilization management activities aimed at providing Molina Healthcare … more
- Molina Healthcare (Albany, NY)
- …benefit management , Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , ... disease management , and evidence-based guidelines. + Experience in Utilization/ Quality Program management + HMO/Managed care experience **PREFERRED LICENSE,… more
- Option Care Health (Albany, NY)
- …Interests (PQIs) Participation in professional organizations related to healthcare , risk management or quality management . Due to state pay transparency ... professional service opportunities into tangible revenue growth and value Proven change management leadership experience related to quality , safety, and improved… more
- CAIPA MSO LLC (New York, NY)
- …New York Downstate area. Its main functions are: Contracting with Payers, Network Management , Healthcare Quality Management , and Credentialing Providers. ... information and respond to questions. + Excellent multi-tasking, prioritizing, and time management skills. + Good aptitude for self-sufficiency with the ability to… more
- Centene Corporation (Latham, NY)
- …in Nursing, Business Administration, or Health Care Administration. 8+ years of quality improvement experience. Healthcare operations management experience ... a strong Medicaid background.** **Position Purpose:** Provide strategic leadership on quality improvement initiatives to ensure best-in-class quality improvement… more
- Molina Healthcare (Buffalo, NY)
- …+ 4+ years in a healthcare analytics role supporting **utilization management , population health, or quality improvement** + Experience working directly with ... **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Healthcare plays a critical role in supporting clinical and operational initiatives by… more
- Molina Healthcare (Buffalo, NY)
- …+ 4+ years in a healthcare analytics role supporting **care management , population health, or quality improvement** + Experience working directly with ... **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst, Healthcare plays a critical role in supporting clinical and operational initiatives by translating … more
- Molina Healthcare (NY)
- …experience on Database technologies, Data Warehouse, Data Validation & Certification, Data Quality , Metadata Management and Data Governance. * Experience with ... Master's Degree **Preferred Experience** * 7-10 years of data management experience. * Experience in the healthcare ...data management experience. * Experience in the healthcare industry is preferred. To all current Molina employees:… more
- Molina Healthcare (Yonkers, NY)
- **Job Summary** This role oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs supporting Medicare ... for ensuring maintenance of programs for members in accordance with prescribed quality standards and provides direction and implementation of key clinical Stars… more