- Evolent (Albany, NY)
- …for utilization management and use of project resources. **Qualifications - Required and Preferred ** + RN Licenses (Active and Unrestricted) - Required + ... with a global workforce and a working knowledge of clinical quality metrics such as HEDIS and NCQA - Preferred . + Skilled in inpatient and outpatient utilization… more
- Elevance Health (Latham, NY)
- …** Preferred skills, qualifications and experiences:** + Certified Case Manager Certification preferred + Utilization management experience highly recommended ... adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting. + Hires, trains, coaches, counsels, and evaluates performance of… more
- Molina Healthcare (NY)
- …Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all ... activities and results to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation + Other… more