• Senior Manager -Quality HEDIS

    CVS Health (NY)
    …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...and statistical analysis to Healthcare Quality metrics spanning NCQA HEDIS measures and CMS Clinical Stars + Apply advanced… more
    CVS Health (01/16/26)
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  • RN Care Manager Complex Pediatric…

    Molina Healthcare (NY)
    JOB DESCRIPTION **Job Summary** The Care Manager provides support for care management/ care coordination activities and collaborates with ... in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network...consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex… more
    Molina Healthcare (01/07/26)
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  • BH Care Manager LCSW, LMFT or LMHC…

    Molina Healthcare (Buffalo, NY)
    …**Preferred Qualifications** * Certified Case Manager (CCM). * Experience in behavioral health care management. * Field-based care management or home ... JOB DESCRIPTION **Job Summary** The Care Manager provides support for ...care . This position will be supporting our Behavioral Health Care Management program. The ideal candidate… more
    Molina Healthcare (01/20/26)
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  • Case Manager , RN or Licensed Behavioral…

    Excellus BlueCross BlueShield (Rochester, NY)
    care plan to identify key strategic interventions to address member's needs, health goals and mitigate health care cost drivers. Essential ... + Works in collaboration with members' physicians and other health care providers to assess the needs...staff, members, and providers. + Provides backup for the Supervisor/ Manager , whenever necessary by: + Participating in the orientation… more
    Excellus BlueCross BlueShield (01/13/26)
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  • AVP, General Manager - Medicare - NY/NJ…

    CVS Health (Albany, NY)
    …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... capabilities, we're joining members on their path to better health and transforming the health care...every day. Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for… more
    CVS Health (01/16/26)
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  • VBC Performance Manager

    Centene Corporation (New York, NY)
    …performance + Drives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + ... for our 28 million members. Centene is transforming the health of our communities, one person at a time....or equivalent experience. Three or more years of managed care or medical group experience, provider relations, quality improvement,… more
    Centene Corporation (01/17/26)
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  • Associate Director of Quality - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …desire to join a fast-paced, growth-oriented environment with a passion for delivering superior health value and improving health care in the US ... The Associate Director of Quality will be the direct manager of the MSHP Quality Care Coordinators....all people, everywhere, by taking on the most complex health care challenges of our time -… more
    Mount Sinai Health System (11/20/25)
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  • Program Manager

    Molina Healthcare (NY)
    …engagement or payer-provider program management. + Experience working in managed care , health plans, or healthcare networks (Medicaid, Medicare, Marketplace). ... initiatives, manages deliverables, and drives continuous improvement to support value-based care and improved member outcomes. **Job Duties** + Responsible for… more
    Molina Healthcare (01/18/26)
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  • Community Connections Representative I/II (Buffalo…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …to detail. * Demonstrated leadership skills. * Demonstrated knowledge and experience of health care industry and Health Plan business. * Demonstrated ... Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC),...high-risk issues. * Conducts targeted phone calls for compliance, HEDIS initiatives and health risk assessments. *… more
    Excellus BlueCross BlueShield (11/19/25)
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  • Lead Technical Product Owner - Next Best Action…

    Humana (Albany, NY)
    …we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These ... part of our caring community and help us put health first** We are building an innovative Next Best...AI decision-making across the enterprise. As Lead Technical Product Manager (PM-T), you will shape the product vision, define… more
    Humana (01/15/26)
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