- Molina Healthcare (Syracuse, 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 (Rochester, NY)
- JOB DESCRIPTION **Job Summary** The Care Manager (RN) provides support for care management/care coordination activities and collaborates with multidisciplinary team ... diabetes, asthma, COPD, and chronic kidney disease/ESRD. Skilled in closing HEDIS , preventive care gaps through proactive outreach and coordination with… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Case Management staff, members, and providers. + Provides backup for the Supervisor/ Manager , whenever necessary by: + Participating in the orientation of new staff ... 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… more
- CDPHP (Latham, NY)
- …Case Management staff, members, and providers. + Provides backup for the Supervisor/ Manager , whenever necessary by: + Participating in the orientation of new staff ... 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… more
- CVS Health (Albany, NY)
- …new and exciting ways every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products in ... sales, marketing, provider relations, network development, utilization management, and/or STARS/ HEDIS quality improvement, and Revenue Integrity efforts. Coordinating and… more
- Molina Healthcare (Buffalo, NY)
- **Job Summary** The Manager , Medical Economics provides support and consultation to the New York Health Plan and Finance team through analyzing key business issues ... sources. + Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** The Regional Manager Value Based Programs plays a critical role in the development and implementation of value-based programs and ... Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge of coding + Knowledge of medical economics and… more
- Vatica Health (Scarsdale, NY)
- The Provider Engagement Manager (PEM I), is an integral role at Vatica, responsible for overall practice success, including but not limited to provider satisfaction, ... BI (Preferred) + Strong knowledge/experience with Quality, Risk Adjustment and Medicare HEDIS /Stars Programs (Preferred) + Experience working in a CRM such as… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …cash controls. + Responsible for monitoring and reporting impact program has to hospital HEDIS measures + Report directly to KPH leadership on the progress of the ... minimum wage requirements. Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/14934/ manager -of-kinney-home-services/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) **Job Locations** _US-NY-East Syracuse_ **Posted… more
- MVP Health Care (Tarrytown, NY)
- …and continuous improvement. To achieve this, we're looking for a **Professional, Case Manager ** to join #TeamMVP. If you have a passion for advocacy, collaboration ... related field (eg, nursing, social work). + Certified Case Manager (CCM) is required within 2 years of employment....Knowledge of Transition of Care (TOC) + Knowledge of HEDIS & Quality Measure + Knowledge of Government Programs… more