• Lead Abstractor, HEDIS /Quality Improvement…

    Molina Healthcare (Albany, NY)
    …Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... + Performs the lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by providers… more
    Molina Healthcare (08/08/25)
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  • Risk & Quality Performance Manager (Remote)

    Molina Healthcare (Albany, NY)
    **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality… more
    Molina Healthcare (07/31/25)
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  • Provider Engagement Account Manager

    Centene Corporation (Queens, NY)
    …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
    Centene Corporation (06/07/25)
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  • Health Plan Pharmacy Services Manager (SC…

    Molina Healthcare (Buffalo, NY)
    …position requires a current South Carolina pharmacist license **Job Summary** The Pharmacy Manager , Health Plan Pharmacy Services is an integral role of the Health ... and Health Education programs including, but not limited to, NCQA Accreditation, HEDIS , and Disease Management programs company wide. + Attends State and Health… more
    Molina Healthcare (07/24/25)
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  • Senior Client Coding Project Manager

    Datavant (Albany, NY)
    …to realize our bold vision for healthcare. As a Sr. Client Coding Project Manager , you will plan, forecast, and manage client-facing coding projects. You will work ... + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. + Familiarity with HIPAA patient privacy requirements. + Excellent… more
    Datavant (06/28/25)
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  • Manager - Health Information Management

    St. Mary's Healthcare (Amsterdam, NY)
    …with the Compliance and Privacy Officer. . Oversees insurance, auditing reviews (ie, HEDIS and /Risk Adjustment), to ensure staff is completing requests in a timely ... manner. . Provides on-going EMR education to providers and staff. Serves as technical expert in health record content and documentation requirements. Utilizes several databases, electronic forms management systems and software to perform required tasks. .… more
    St. Mary's Healthcare (07/18/25)
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  • Consultative Coding Professional

    CenterWell (Albany, NY)
    …opportunities. + Perform individual chart research as requested. + Collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies. ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
    CenterWell (08/08/25)
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  • Supervisor, Clinical Pharmacy/MTM - Remote

    Molina Healthcare (NY)
    …Medicaid eligible members as well as Medication Adherence Programs for STAR, HEDIS and behavioral health medications. * Ensures that adequate staffing coverage is ... to determine which recommended changes to drug therapy were implemented. * Assists Manager or Director in the collection and tabulation of data for reporting… more
    Molina Healthcare (08/08/25)
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  • Medical Receptionist TRI Ortho

    Catholic Health (Williamsville, NY)
    …: The Medical Receptionist is under the direct supervision of the office manager or practice administrator to optimize patient experience by performing a number of ... the department + Knowledge of Patient Centered Medical Home, with MIPS, HEDIS requirements preferred (Primary Care) WORKING CONDITIONS: ENVIRONMENT + Ability to… more
    Catholic Health (08/08/25)
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  • Transition of Care Coach (RN) Remote based in New…

    Molina Healthcare (Bronx, NY)
    …medical conditions such as diabetes, COPD, and hypertension. Skilled in closing HEDIS and preventive care gaps through proactive outreach and coordination with ... Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM) To all current Molina employees: If you are interested… more
    Molina Healthcare (08/08/25)
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