• Network Development and Contracting (Value Based…

    CVS Health (Albany, NY)
    …and every day. **Position Summary** + The Medicaid VBS Network State Manager manages and oversees compliance with our Network responsibilities as provided within ... to obtain crucial or required information from Providers, such as HEDIS , Credentialing, Grievance and Appeals, SIU, etc. Coordinates provider status information… more
    CVS Health (11/20/25)
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  • Associate Director of Quality - Mount Sinai Health…

    Mount Sinai Health System (New York, NY)
    …Engagement. The Associate Director of Quality will be the direct manager of the MSHP Quality Care Coordinators. **Qualifications** **Education and Experience** ... contact for payer quality reporting * Content expertise for standard quality measures ( HEDIS , PQRS, MIPS, etc.) * Interface with analytics, IT, and providers to… more
    Mount Sinai Health System (11/20/25)
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  • Community Connections Representative I/II (Buffalo…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …and other high-risk issues. * Conducts targeted phone calls for compliance, HEDIS initiatives and health risk assessments. * Collaborate with Case Management on ... organization meetings as required/complement or collaboration with Community Engagement Program Manager . * Gain Subject Matter Expertise (SME) level in key focus… more
    Excellus BlueCross BlueShield (11/19/25)
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  • Specialist, Quality Interventions/QI Compliance…

    Molina Healthcare (Yonkers, NY)
    …activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + ... Certification, Association** + Certified Professional in Health Quality (CPHQ) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more
    Molina Healthcare (11/07/25)
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