• HEDIS Program Manager

    CVS Health (Albany, NY)
    …excellence in healthcare delivery. + Educates internal and external stakeholders on HEDIS program needs and compliance requirements. + Generates and interprets ... process improvement methodologies. **Required Qualifications** 3-5 years progressive experience in HEDIS data analysis program management in managed care… more
    CVS Health (08/01/25)
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  • Strategic HEDIS Data Analysis…

    CVS Health (Albany, NY)
    …This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our ... future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive… more
    CVS Health (07/31/25)
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  • Population Health Manager

    Apicha Community Health Center (New York, NY)
    …for underserved and vulnerable populations. Position Summary The Population Health Manager collaborates with a multidisciplinary staff to meet Population Health and ... the mission of Apicha and its strategic goals. The Population Health Manager supports the implementation of strategies to drive clinical transformation toward… more
    Apicha Community Health Center (05/22/25)
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  • Risk & Quality Performance Manager (Remote)

    Molina Healthcare (Albany, 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 (07/31/25)
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  • Provider Engagement Account Manager

    Centene Corporation (Queens, NY)
    …improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS /quality, cost and utilization, etc. + Completes special projects as assigned ... at a medical group, IPA, or health plan setting. Proficient in HEDIS /Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene… more
    Centene Corporation (06/07/25)
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  • Case Manager , RN or Licensed Behavioral…

    Excellus BlueCross BlueShield (Rochester, NY)
    Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for ... Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the… more
    Excellus BlueCross BlueShield (06/27/25)
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  • Health Plan Pharmacy Services Manager (SC…

    Molina Healthcare (Buffalo, NY)
    …position requires a current South Carolina pharmacist license **Job Summary** The Pharmacy Manager , Health Plan Pharmacy Services is an integral role of the Health ... Director or AVP to ensure that the Health Plan Pharmacy Program is consistent with Molina's overall pharmacy strategy. **KNOWLEDGE/SKILLS/ABILITIES** + Provides… more
    Molina Healthcare (07/24/25)
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  • Manager - Health Information Management

    St. Mary's Healthcare (Amsterdam, NY)
    …Region to earn the distinction since the Times Union launched the recognition program 14 years ago. Job Requisition: REQ3517 Employment Type: Full-Time Shift: Days ... with the Compliance and Privacy Officer. . Oversees insurance, auditing reviews (ie, HEDIS and /Risk Adjustment), to ensure staff is completing requests in a timely… more
    St. Mary's Healthcare (07/18/25)
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  • Supervisor, Clinical Pharmacy/MTM - Remote

    Molina Healthcare (Albany, NY)
    …Medicaid eligible members as well as Medication Adherence Programs for STAR, HEDIS and behavioral health medications. * Ensures that adequate staffing coverage is ... all CMS guidelines and reporting requirements for the MTM Program ; fulfills all required process and outcome measurements and...recommended changes to drug therapy were implemented. * Assists Manager or Director in the collection and tabulation of… more
    Molina Healthcare (07/09/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (NY)
    …quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key ... + Acts as a lead specialist to provide project, program , and/or initiative related direction and guidance for other...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… more
    Molina Healthcare (07/31/25)
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