Quality Analyst - Healthcare Operations
EmblemHealth - Melville, NY
Responsible for the satisfaction of internal and external requirements in support of EmblemHealthâs HEDIS/QARR reporting responsibilities. This includes implementation, administration and the communication of results and findings to appropriate departments. This position provides...
EmblemHealth - New York City, NY
Summary: This position has accountability for oversight and management of specific vendor contracts in Provider Network Management. This includes managing day to day operations for all activities related to vendor contracts and optimizing contract performance. Additionally, this ...
EmblemHealth - Albany, NY
This position is located in the EmblemHealth Albany, NY office. The Provider Relations Manager is responsible for provider network development, network servicing, Provider Relations field Coordinator management, assistance to other Plan departments for inquiries related to provid...
Pharmacist - Case Manager - Harlem/Upper West Side
EmblemHealth - New York City, NY
Do you feel compelled to help people in need? Do people naturally feel comfortable speaking with you? Would you like to be a part of something exciting and unique, focusing on making a positive difference in our customers? lives? If so, we are currently seeking a Pharmacy Case Ma...
EmblemHealth - Hollywood, FL
This position will be responsible for facilitating formal and informal training classes for the Member Service, Claim Operations and other operational areas of EmblemHealth using Adult Learning techniques. The Trainer is responsible for training new hire classes as well as topics...
EmblemHealth - New York City, NY
Execute a variety of analytical exercises with respect to provider and facility billing patterns to provide operations and medical management with actionable, high quality quantitative information that drives effective business decision making, enables interpretation of current, ...
Pharmacy Financial Analysis Leader
EmblemHealth - New York City, NY
Essential Duties: The Pharmacy Financial Analysis Lead reports to the VP of Pharmacy Services, and will lead a staff of analysts and manage all pharmacy finance reporting including the detailed analysis of pharmacy trends, rebated, PMPM. PMPY, pharmacy dashboards, RFP submissions...
Group Practice/ Provider Relations Specialist
EmblemHealth - New York City, NY
The Senior Group Practice Specialist will serve as liaison between EmblemHealth and the medical groups with respect to contract administration and practice improvement support.Principal AccountabilitiesAccountabilities: Manage and administer provisions of the medical group contra...
Sr. Acct Director, Sales & Marketing
EmblemHealth - New York City, NY
Our firm currently has an opening for a Sr. Account Director, Sales and Marketing which will provide highly technical guidance and solutions to complex IT problems to EmblemHealth business units by evaluating existing or new systems/applications and recommending appropriate syste...