• Ambulatory Care Manager (RN)

    Rochester Regional Health (Rochester, NY)
    …and huddles as appropriate; * Conduct pre-visit planning and post-visit follow-up for care managed patients; * Provide feedback to providers regarding patient ... Job Title: Ambulatory Care Manager Location: Wilson Multicultural Medical Campus -...lead and facilitate a team approach to population-based care + Critical thinking skills, decisive judgement + Exceptional… more
    Rochester Regional Health (09/26/25)
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  • Director, Provider Contracts (Must reside…

    Molina Healthcare (Rochester, NY)
    …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including 2+ years ... with other operational departments and functional business unit stakeholders to lead or support various Provider Contracting functions. This role primarily leads… more
    Molina Healthcare (10/05/25)
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  • Lead Director, Product Mgt & Development…

    CVS Health (NY)
    …open to qualified candidates within the United States. **Required Qualifications** 10+ years of Managed Care experience in health plan and/or PBM roles 10+ years ... CMS audit experience HPMS experience **Preferred Qualifications** 15+ years of Managed Care experience in health plan and/or PBM roles 15+ years Medicare… more
    CVS Health (09/24/25)
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  • Medicaid State Technology Lead

    Humana (Albany, NY)
    …policy administration or related field;work experience may meet this need + 5 + years managed care experience + 5 + years in Medicaid program implementation or ... and clinical operations; Medicaid preferred + Comprehensive understanding of a Medicaid Managed Care architecture, tools, utilities and processes utilized to… more
    Humana (09/03/25)
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  • Field Medical Outcomes, Director, MD

    Pfizer (Albany, NY)
    …as appropriate. The individual may be involved in presentations to payers, managed care organizations, formulary decision makers and regional medical advisory ... of the following: + Clinical, formulary, and/or other management experience + Managed Care , pharmaceutical industry, and/or Quality Improvement + Data Analytics… more
    Pfizer (10/02/25)
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  • Health Benefit Rep - Bronx (Bilingual)

    Centene Corporation (Bronx, NY)
    …including "metal" products offered through the New York State of Health (NYSOH), Medicaid Managed Care , Child Health Plus, Medicare, MLTC, FIDA and HARP. Ability ... the Sales Force CRM as an activity tracking and lead /referral tracking tool, to manage appointments and follow up,...GED, required. 2 to 5 years prior experience in managed care , sales, customer service or related… more
    Centene Corporation (10/05/25)
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  • Medical Director (AZ)

    Molina Healthcare (Syracuse, NY)
    …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
    Molina Healthcare (09/26/25)
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  • Director of Revenue Engagement- Patient Financial…

    Mount Sinai Health System (New York, NY)
    …strong, collaborative relationships with cross-functional stakeholders including DTP, Human Performance, Managed Care , Finance, and clinical departments. * Work ... with finance and managed care teams to improve registration, coding,...guide necessary updates to internal processes. **Team Leadership** * Lead , mentor, and support revenue cycle and engagement staff.… more
    Mount Sinai Health System (08/21/25)
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  • Vice President, Growth - Payer

    Evolent (Albany, NY)
    …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... **:** The **VP,** **Growth** **-** **Pay** **e** **r** will lead strategic partnerships with health plans. + Develop and...cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers… more
    Evolent (09/15/25)
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  • Lead Analyst, Quality Analytics…

    Molina Healthcare (Buffalo, NY)
    …for Medicaid, Marketplace and Medicare/MMP * Develops custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates ... **Job Summary** The Lead Analyst, Quality Analytics and Performance Improvement role...cleaning of data. * 5+ Years of experience in Managed Care Organization executing similar techno functional… more
    Molina Healthcare (08/17/25)
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