• Senior Abstractor, HEDIS / Quality…

    Molina Healthcare (Syracuse, NY)
    …National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Assists with projects and ... **C** **E/KNOWLEDGE, SKILLS & ABILITIES:** + 3 years experience in healthcare Quality / HEDIS specific to medical record review and abstraction + Intermediate… more
    Molina Healthcare (12/20/25)
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  • Sr. Data Analyst/Risk Adjustment - US Remote

    Datavant (Albany, NY)
    …prevalence and hierarchy + Experience managing data flows for chart retrieval, RA coding, HEDIS abstraction and quality + Ability to build, architect and deliver ... is focused on ensuring the work we do for our customers is of the highest quality and yields positive outcomes. To achieve this, you will leverage a wide array of… more
    Datavant (12/25/25)
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  • Medical Director, Commercial Line of Business

    Excellus BlueCross BlueShield (Rochester, NY)
    …management, decision-making, and problem-solving skills. + Knowledge of credentialing, quality , NCQA/ HEDIS /CMS and/or Medicaid Star Ratings, and/or value-based ... including, but not limited to, Medical and Pharmacy Utilization Management, quality management, member care management, and medical policy processes, and support… more
    Excellus BlueCross BlueShield (12/29/25)
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  • RN

    Catholic Health Services (Melville, NY)
    …staff. + Participates in staff meetings and huddles as appropriate. + Participates in Hedis , GPRO, and other quality programs as needed + Enters provider orders ... must show an uncompromising commitment to providing the highest quality of patient care by being an integral part...into the electronic record for provider review and signature + Preforms AWV + Patient counseling… more
    Catholic Health Services (12/16/25)
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  • Leader, Quality Analytics Operations

    MVP Health Care (Rochester, NY)
    …every day. We've been putting people first for over 40 years, offering high- quality health plans across New York and Vermont and partnering with forward-thinking ... experience. + Three years' experience with data analysis and/or health care quality operations. + Possess strong personnel management skills. + Experience with … more
    MVP Health Care (01/03/26)
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  • Case Manager, RN (Multiple Openings!)

    Excellus BlueCross BlueShield (Rochester, NY)
    …Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case ... for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources.… more
    Excellus BlueCross BlueShield (01/13/26)
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