ncqa jobs in New York

Summary Of Position Provide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face-to-face assessments of members’ health care needs, identifying gaps in care and needed support, administering/coordinating implementation of interventions. Support and enable members to manage their...

Summary of PositionProvide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face-to-face assessments of members’ health care needs, identifying gaps in care and needed support, administering/coordinating implementation of interventions. Support and enable members to manage their...

18 physician multi-specialty group, seeks a BE/BC Endocrinologist interested in joining a dynamic practice located in the heart of the scenic Hudson Valley. 1 other Endocrinologist on the team.We are recognized by NCQA as a Level 3 Medical Home and as a Patient Centered Specialty Practice Level 3 one of 73 nationally . We are additionally in the NCQA...

OverviewSupports interdepartmental Quality Improvement (QI) initiatives focused on promoting high-quality, safe, and equitable member care. Serves as a clinical and operational resource to QI committees, workgroups, and leadership. Analyzes outcomes, HEDIS/CAHPS/Stars performance, and trend data to identify opportunities for improvement in care coordination,...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers,...

Lead the Transformation in Oncology Care At Evolent, we re redefining how care is delivered for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal role in advancing value-based care models that prioritize clinical excellence, patient-centered outcomes, and system-wide impact. This role offers the...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical determinations, and ensuring accurate member and provider communications. In collaboration with Medical Directors and...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved...

REMOTE Summary Of Position • Responsible for ongoing business support of the Operational functions, including new or revised product implementations, accreditation, contracts, compliance requirements and internal and external regulatory or client audits. • Lead and support implementations of new processes within operations, interfacing with Product,...

Summary Of Position Lead the implementation of the quality department digital HEDIS strategy under the quality measurement analytics team. Lead efforts to continually improve data capabilities and quality of department analysis and reporting. Develop and implement automation of manual reporting and analysis of business implications and trends. Develop,...

Summary Of Job Accountable for oversight and management of specific provider contracts in Provider Network Management. Lead day to day operations for all activities related to contracts, contract optimization, implementation of new programs and business ownership of all EPMO and IT projects associated with contracts. Foster strong relationships across...

Summary Of Position Provide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face-to-face assessments of members’ health care needs, identifying gaps in care and needed support, administering/coordinating implementation of interventions. Support and enable members to manage their...

New York City based Hybrid role Requirement 2 days (Thursday & Fridays 8:00am-6:00pm) - ACPNY location at 115 Chambers St. New York, NY Monday, Tuesday & Wednesday work from home Summary Of Position Provide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face-to-face assessments of...

Summary Of Position Provide analysis, reporting, and predictive modeling to support the quality department digital HEDIS strategy under the quality measurement analytics team. Implement automation of manual reporting and analysis of business implications and trends. Automate the intake, use and data governance of clinical and supplemental data sources to...

Summary of PositionProvide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face-to-face assessments of members’ health care needs, identifying gaps in care and needed support, administering/coordinating implementation of interventions.  Support and enable members to manage their...

About Judi Health Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a...

Summary Of Position • Lead the strategic redesign, operational performance, and day-to-day management of the health plan’s Utilization Management function across Medicaid, Commercial, and Medicare lines of business. • Provide senior clinical and operational leadership for the health plan’s Utilization Management department and function across...

DescriptionThe Union Health Center (UHC) is seeking a full-time Primary Care Provider to join our team!BackgroundThe Union Health Center (UHC) is an innovative primary and multi-specialty center focused on providing well-coordinated and accessible healthcare. UHC has been providing care to New Yorkers for over one hundred years, founded by the International...

Responsible for the overall clinical management of the practice and program assigned to the practice as above, including direct supervision of all providers (Medical, and monitoring the practice and on-site programs for meeting the organizations productivity goals, quality performance measures, regulatory compliance, and research initiatives. Responsible for...

DescriptionThe Union Health Center (UHC) is seeking a full-time Primary Care Provider to join our team!BackgroundThe Union Health Center (UHC) is an innovative primary and multi-specialty center focused on providing well-coordinated and accessible healthcare. UHC has been providing care to New Yorkers for over one hundred years, founded by the International...