Trabajos hedis en Jersey City, New JerseyCrear alertas

Overview Provides clinical leadership to promote increased compliance with a range of quality and cost measures and standards of care. Manages service delivery of inter-professional and para-professional team members working on an individual case or population of cases. Acts as a key resource in providing clinical and operational guidance and support to assigned teams and other staff to achieve and enhance team outcomes. Provides advanced nursing clinical care for patients in accordance with current State and Federal rules and regulations for nurse practitioner's scope of practice and national standards of care. Works under the supervision of the Clinical Director for the Nurse Practitioner Program. What We Provide * Personal and financial wellness programs * Opportunities for professional growth and career advancement * Internal mobility and advancement opportunities * Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals What You Will Do * Manages and provides full scope of advanced nursing practice for targeted patient populations. Evaluates patient responses to therapy / interventions. Ensures revision of the inter-professional plan of care as necessary to achieve quality outcomes. * Identifies need for new/revised clinical protocols. Collaborates with physicians and others within the practice to develop protocols and provides training as appropriate. * Manages and provides comprehensive advanced nursing care including physical examination, comprehensive history, screening for physical and/or psychological conditions, emergent interventions, pharmacological and non-pharmacological interventions, ordering treatments and DME, preventative health maintenance activities, care management, referrals, discharge planning, counseling and patient education. Establishes a treatment plan based on clinical findings and. Determines when further evaluation by collaborating physician, specialist or emergency care is warranted. * Collaborates with patients, families, primary care physicians and other team members to provide assessment and care planning. Assesses, plans, and provides intensive and continuous care management across client settings. * Manages and provides clinical services in compliance with standards of Patient-Centered Medical Home standards, meaningful use of medical record data, HEDIS and QARR quality of care measurements. Qualifications Licenses and Certifications: • License and current registration to practice as a Registered Professional Nurse in New York State required, • Certificate (license) and current registration to practice as a Nurse Practitioner in the State of New York, with a specialty in adult health, family health or gerontology required, • Valid driver's license, as determined by operational/regional needs may be required, • Maintains credentialed status with VNS Health Medical Care at Home and associated managed care plans required, • Maintains NPI, Medicaid and Medicare provider numbers preferred, • Maintains a collaborative practice agreement with a physician in compliance with New York State regulations preferred, • Must be certified by ANCC or another accrediting Nurse Practitioner body – in order to bill Medicare and meet credentialing requirements required, • For Psychiatric Nurse Practitioners only:, • Current PMHNP-BC certification required Education: • Master's Degree of Science in Nursing, or other graduate degree from a nurse practitioner educational program registered by the New York State Education Department as qualifying for NP certification (licensure) required, • Current ANCC or AANP certification as an adult, family or geriatric nurse practitioner required, • For Psychiatric Nurse Practitioners only:, • Master's Degree in psychiatric-mental health Nurse Practitioner required, • PhD in psychiatric-mental health Nurse Practitioner preferred Work Experience: • Minimum of two years of experience as a nurse practitioner utilizing full scope of practice preferred, • Clinical home care experience or two years managerial experience preferred, • Demonstrated knowledge of Hedis and QARR quality measures, ICD-10 and CPT coding for reimbursement of services required, • Bilingual skills, as determined by operational needs required Pay Range USD $58.30 - USD $77.72 /Hr. About Us VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us — we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

Overview Provides clinical leadership to promote increased compliance with a range of quality and cost measures and standards of care. Manages service delivery of inter-professional and para-professional team members working on an individual case or population of cases. Acts as a key resource in providing clinical and operational guidance and support to assigned teams and other staff to achieve and enhance team outcomes. Provides advanced nursing clinical care for patients in accordance with current State and Federal rules and regulations for nurse practitioner's scope of practice and national standards of care. Works under the supervision of the Clinical Director for the Nurse Practitioner Program. What We Provide • Referral bonus opportunities, • Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays, • Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability, • Employer-matched retirement saving funds, • Personal and financial wellness programs, • Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care, • Generous tuition reimbursement for qualifying degrees, • Opportunities for professional growth and career advancement, • Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities What You Will Do • Manages and provides the full scope of advanced nursing practice for targeted patient populations, which may include short-term treatment of members at the point of care. Evaluates patient responses to therapy/interventions. Ensures revision of the inter-professional plan of care as necessary to achieve quality outcomes., • Serves as the clinical authority on individualized care teams and leads rounds and interdisciplinary care team meetings., • Manages and provides comprehensive, advanced nursing care, including post-discharge aftercare visits, annual comprehensive assessment visits, palliative care-care management program onboarding, and change in condition assessment visits (including physical examination, comprehensive history, screening for physical and/or psychological conditions, and point of care testing). Urgent interventions (i.e., escalations for the Care Teams, RPM, and the 24/7 Line), pharmacological and non-pharmacological interventions, ordering treatments and DME, preventative health maintenance activities, care management, referrals, discharge planning, counseling, and patient education. Establishes a treatment plan based on clinical findings and determines when further evaluation by the collaborating physician, specialist, or emergency care is warranted., • Collaborates with patients, families, primary care physicians and other team members to provide assessment and care planning. Assesses, plans, and provides intensive and continuous care management across client settings., • Manages and provides clinical services in compliance with standards of Patient-Centered Medical Home standards, meaningful use of medical record data, HEDIS and QARR quality of care measurements., • Manages inter-professional team efforts regarding the medical, nursing, therapy and ancillary care provided to patients to ensure quality outcomes are achieved., • Participates in on call coverage schedule to ensure 24/7 access to practice clinicians., • Assesses, educates, and improves client and caregiver knowledge of chronic disease, self-care management, and identification of changes in health status, including appropriate responses and actions through individualized education and inter-professional interventions., • Observes and analyzes team performance patterns related to population under care and assists in developing interventions to improve team performance. Provides remedial support and guidance to interdisciplinary team members to address implementation/evaluation of plans that maintain/increase customer experience with care, cost-efficiency, and quality care compliance with regulatory standards., • Communicates with internal and external care partners regarding the needs of the patient or population to ensure interventions occur in a timely and appropriate manner. Intervenes as needed when the care plan is not executed and remediates the situation to prevent reoccurrence., • Performs procedures as outlined in collaborative practice agreement and as privileged by the Credentialing Committee., • Manages quality of medical record documentation and submits billing information in accordance with Professional Corporation policy., • Provides care in one or more care settings based on the clinical requirements: virtually, telephonically or travels to patients’ homes and/or other facilities with varying environments (e.g., elevated buildings, walk-ups, care facilities, single/multiple family homes, presence of pets, etc.) using approved transportation options., • Upon request, performs peer reviews of work performance, including quality of care, clinical documentation, coding and billing practices, communication skills, and population surveillance., • May participate in the VNS Health Medical Care at Home Quality and Professional Advisory Committee and any associated workgroups related to development of evidence based clinical models of care, peer education and training, quality improvement, medical record configuration and reporting, maximizing the use of clinical decision support systems., • May act as a preceptor for student Nurse Practitioners, providing excellent role modeling of community-based primary care practice., • Assumes responsibility for continued professional growth, and maintains professional certification and licensure. Licenses and Certifications: * License and current registration to practice as a Registered Professional Nurse in New York State required * Certificate (license) and current registration to practice as a Nurse Practitioner in the State of New York, with a specialty in adult health, family health or gerontology required * Valid driver's license, as determined by operational/regional needs may be required * Maintains credentialed status with VNS Health Medical Care at Home and associated managed care plans required * Maintains NPI, Medicaid and Medicare provider numbers preferred * Maintains a collaborative practice agreement with a physician in compliance with New York State regulations preferred * Must be certified by ANCC or another accrediting Nurse Practitioner body – in order to bill Medicare and meet credentialing requirements required Education: * Master's Degree of Science in Nursing, or other graduate degree from a nurse practitioner educational program registered by the New York State Education Department as qualifying for NP certification (licensure) required * Current ANCC or AANP certification as an adult, family or geriatric nurse practitioner required Work Experience: * Minimum of two years of experience as a nurse practitioner utilizing full scope of practice preferred * Clinical home care experience or two years managerial experience preferred * Demonstrated knowledge of HEDIS and QARR quality measures, ICD-10 and CPT coding for reimbursement of services required * Bilingual skills, as determined by operational needs required Pay Range USD $109,900.00 - USD $146,500.00 /Yr. About Us VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us — we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

Overview Provides clinical leadership to promote increased compliance with a range of quality and cost measures and standards of care. Manages service delivery of inter-professional and para-professional team members working on an individual case or population of cases. Acts as a key resource in providing clinical and operational guidance and support to assigned teams and other staff to achieve and enhance team outcomes. Provides advanced nursing clinical care for patients in accordance with current State and Federal rules and regulations for nurse practitioner's scope of practice and national standards of care. Works under the supervision of the Clinical Director for the Nurse Practitioner Program. What We Provide • Personal and financial wellness programs, • Opportunities for professional growth and career advancement, • Internal mobility and advancement opportunities, • Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals What You Will Do, • Manages and provides full scope of advanced nursing practice for targeted patient populations. Evaluates patient responses to therapy / interventions. Ensures revision of the inter-professional plan of care as necessary to achieve quality outcomes., • Identifies need for new/revised clinical protocols. Collaborates with physicians and others within the practice to develop protocols and provides training as appropriate., • Manages and provides comprehensive advanced nursing care including physical examination, comprehensive history, screening for physical and/or psychological conditions, emergent interventions, pharmacological and non-pharmacological interventions, ordering treatments and DME, preventative health maintenance activities, care management, referrals, discharge planning, counseling and patient education. Establishes a treatment plan based on clinical findings and. Determines when further evaluation by collaborating physician, specialist or emergency care is warranted., • Collaborates with patients, families, primary care physicians and other team members to provide assessment and care planning. Assesses, plans, and provides intensive and continuous care management across client settings., • Manages and provides clinical services in compliance with standards of Patient-Centered Medical Home standards, meaningful use of medical record data, HEDIS and QARR quality of care measurements. Qualifications Licenses and Certifications: • License and current registration to practice as a Registered Professional Nurse in New York State required, • Certificate (license) and current registration to practice as a Nurse Practitioner in the State of New York, with a specialty in adult health, family health or gerontology required, • Valid driver's license, as determined by operational/regional needs may be required, • Maintains credentialed status with VNS Health Medical Care at Home and associated managed care plans required, • Maintains NPI, Medicaid and Medicare provider numbers preferred, • Maintains a collaborative practice agreement with a physician in compliance with New York State regulations preferred, • Must be certified by ANCC or another accrediting Nurse Practitioner body – in order to bill Medicare and meet credentialing requirements required, • For Psychiatric Nurse Practitioners only:, • Master's Degree of Science in Nursing, or other graduate degree from a nurse practitioner educational program registered by the New York State Education Department as qualifying for NP certification (licensure) required, • Current ANCC or AANP certification as an adult, family or geriatric nurse practitioner required, • For Psychiatric Nurse Practitioners only:, • Master's Degree in psychiatric-mental health Nurse Practitioner required, • Minimum of two years of experience as a nurse practitioner utilizing full scope of practice preferred, • Clinical home care experience or two years managerial experience preferred, • Demonstrated knowledge of Hedis and QARR quality measures, ICD-10 and CPT coding for reimbursement of services required, • Bilingual skills, as determined by operational needs required Pay Range USD $109,900.00 - USD $146,500.00 /Yr. About Us VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us — we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

Overview Leads 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, quality, and member experience. Designs, implements, and evaluates QI programs aligned with DOH, CMS, and NCQA standards. Collaborates across departments—including Care Management, Utilization Management, Provider Relations, Compliance, and Analytics—to sustain continuous improvement, advance health equity, and ensure regulatory readiness. What We Provide * Referral bonus opportunities * Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays * Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability * Employer-matched retirement saving funds * Personal and financial wellness programs * Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care * Generous tuition reimbursement for qualifying degrees * Opportunities for professional growth and career advancement * Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities What You Will Do • Conducts clinical assessment including and not limited to, medication reconciliations, post-discharge transitions of care assessment and follow-up post emergency department assessment, • Collaborates across departments to ensure compliance with DOH, CMS, and NCQA requirements. Coaches teams in applying continuous improvement methodologies (PDSA, LEAN, RCA) to achieve strategic objectives and national benchmarks for quality, satisfaction, and cost. Partners with analytics and program teams to identify trends and address performance gaps., • Performs clinical reviews with network providers to validate diagnoses, address care gaps, and support accurate HEDIS/QARR documentation. Collaborates with providers to improve adherence to evidence-based care and quality measures., • Leads and participates in multidisciplinary QI teams and committees to design, implement, and evaluate improvement initiatives related to clinical performance, documentation, and regulatory compliance. Supports development of annual QI work plan, program evaluation, and performance reporting. Supports value-based programs through data review, gap identification, and provider feedback., • Performs medical record audits to evaluate adherence to documentation, coding, and quality standards. Provides education, feedback, and guidance to PCPs on VNS Health Medical Record Documentation Standards., • Conducts audits of patient care records to monitor care quality and documentation accuracy.. Develops forms, record abstracts, reports, and other tools used to implement concurrent and retrospective patient care review, including the design, testing and evaluation of the review methodology., • Performs utilization and quality assessment reviews to maintain compliance with Federal and State regulatory requirements. Identifies & analyzes results to inform the development of correction plans., • Collaborates with management to develop measurable action plans based on root-cause analysis, outcome trends, and survey results (HEDIS, CAHPS, Stars). Presents recommendations to QI committees and leadership to drive improvement and accountability., • Participates in the preparation for and assists with site visits of external providers for the purpose of regulatory quality compliance., • Develops and disseminates training materials, clinical guidelines, and quality protocols to promote consistent evidence-based care across provider networks and internal teams. Provides education sessions and quality coaching as needed., • Conducts follow-up reviews and reassessments to ensure corrective actions for regulatory findings, complaints, or incidents are implemented effectively and sustained over time. Documents progress and escalates unresolved issues as appropriate., • Develops, maintains, and updates QI policies and procedures aligned with evolving regulatory and industry standards. Collaborates with analytics to collect, interpret, and share performance data with internal teams to drive transparency and accountability. Licenses and Certifications: • License and current registration to practice as a Registered Professional Nurse in New York State or New Jersey required Education: • Bachelor's Degree Nursing required Work Experience: • Minimum of three years experience in a health plan or health care, setting required, • Minimum of three years quality improvement experience preferred, • Minimum of one year experience, quality management, practice improvement and compliance preferred, • Demonstrated experience leading or facilitating cross-functional quality initiatives preferred, • Excellent oral, written and interpersonal communication skills, including group facilitation skills required, • Knowledge of basic Performance Improvement tools and methodologies (e.g., PDSA, LEAN, Six Sigma). preferred Pay Range USD $85,000.00 - USD $106,300.00 /Yr. About Us VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us — we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

Work Location: NY/NJ Work Setting: Hybrid About NSIPA: Network Solutions IPA (NSIPA) is a leading New York–based Independent Practice Association with a diverse, multi-specialty provider network. The organization has grown to more than 600 physician members, serving over 100,000 patients across New York City, Nassau, Suffolk, and Westchester counties. We are committed to helping independent providers succeed in the transition to value-based care. Through strategic partnerships, operational support, and robust payer relationships, NSIPA delivers the tools, resources, and expertise that allow practices to grow, perform, and succeed in today’s complex healthcare landscape without sacrificing independence. We achieve this by collaborating with payers to deliver Quality Incentive Programs, Shared Savings arrangements, and Risk-Based Contracts. Contracted with over 21+ Payers for over 600+ Providers. NSIPA provides a comprehensive suite of services, including credentialing and network operations, provider engagement, and contracting; care coordination and member outreach; and provider-and patient centered programs. As part of New York State’s 1115 Medicaid Waiver, NSIPA plays a key role in identifying, screening, and addressing health-related social needs by connecting Medicaid members to community-based resources and care supports. These services are designed to strengthen provider efficiency, address health related social care needs, and advance value‑based care and population health opportunities. Recognized as one of New York’s fastest‑growing IPAs, NSIPA supports improved clinical outcomes, enhanced provider performance, and cost savings for payers through its robust infrastructure and operational expertise. Position Overview: We are seeking an experienced leader to oversee NSIPA’s value-based care strategy and quality performance across all payer contracts. This role is responsible for improving clinical quality, utilization, and financial outcomes while driving population health initiatives and ensuring strong performance under value-based and risk-based arrangements. The Director will lead the Population Health Quality team and collaborate with executive leadership, providers, payers, and cross‑functional teams to drive measurable improvements in cost, quality, and care delivery. This is an ideal opportunity for a seasoned leader who thrives in complex, multi‑payer environments and is passionate about improving care for Medicare, Medicaid, and managed care populations. Roles & Responsibilities: · Own NSIPA’s value-based care and quality improvement strategy across all payer programs. · Oversee performance related to MER, total cost of care, utilization, and quality outcomes. · Partner with executive leadership and cross-functional teams to identify performance risks, opportunities, and intervention strategies. · Lead quality programs including HEDIS, QARR, CAHPS measures, medication adherence and transitions of care. · Develop and execute performance improvements and corrective action plans. · Oversee performance monitoring and improvement initiatives related to quality, utilization, and total cost of care metrics. · Collaborate with Provider Engagement to support underperforming providers and ensure documentation and quality standards are met. · Partner with Data & Analytics to turn complex claims, EHR, and payer data into actionable insights. · Build and guide a high-performing Population Health Quality team. · Provide oversight of the Peer Review Committee (PRC), including case review, provider communication, documentation, and reporting. · Serve as a key liaison with payer partners on VBC performance, quality initiatives, and contractual requirements. · Ensure compliance with regulatory, audit, and accreditation standards. · Support performance strategies under risk-based, shared savings, and value-based arrangements. · Responsible for developing educational materials and resources, including content, brochures, and one-pagers, centered on quality and value-based care (VBC) initiatives to support provider and staff education and performance improvement efforts. Skills & Competencies: · Strong understanding of value-based care, population health, and risk arrangements. · Expertise in quality measurement (HEDIS, QARR, CAHPS, CMS). · Advanced analytical skills with the ability to interpret and act on complex data. · Strong leadership, communication, and cross-functional collaboration skills. · Ability to manage multiple priorities in a fast-paced environment. · Proficiency in MS Office, experience with data visualization tools (Tableau) or similar tools preferred. Required Qualifications: · Bachelor's degree in a health-related field · Clinical background (RN preferred) or relevant quality credential · 5+ years of experience in value-based care, quality improvement, or population health. · 3+ years of experience in a health plan, IPA, MSO, or integrated delivery system. · Experience managing performance across multiple-payer contracts. · Prior leadership and people management experience. Salary Range: $120000 - $140000 Why Join NSIPA? · High-impact leadership role with direct influence on organizational strategy. · Opportunity to shape the future of value-based care across diverse populations. · Collaborative, mission-driven environment focused on improving patient outcomes. · Visibility, growth, and the ability to build and scale performance programs. Physical Demands: The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel; make precisely coordinated movements of the fingers of one or both hands to grasp, manipulate, or utilize computer equipment; reach with hands and arms; and talk or hear. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, ability to adjust focus and ability to match or detect differences between colors, including shades of color and brightness. EEO Statement: NSIPA is an equal opportunity employer committed to diversity and inclusion. We encourage applications from all qualified individuals regardless of race, color, religion, gender, sexual orientation, age, national origin, disability, or veteran status.

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: • Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,, • Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Position Summary: This individual will report to the Associate Director of Clinical Programs Business Development and be responsible for supporting the sales and profitability of Capital Rx's suite of clinical programs. This role serves as a primary business development lead for clinical offerings, from opportunity identification, client presentations, to negotiations and contracting. This role will drive clinical programs sales to new and existing PBM clients and foster strategic relationships with consultant groups. The ideal candidate will combine clinical expertise with strategic sales acumen to expand program adoption and deliver measurable value to clients. This is a base salary plus commission role. Position Responsibilities: • Drive the sales strategy for Capital Rx's suite of clinical programs end-to-end from prospecting through close., • Proactively assess client data to identify opportunities, meet with account teams to qualify opportunities, and deliver compelling presentations, proposals, and ROI analyses to prospects to drive clinical program sales., • Develop and implement strategic plans to identify, engage, and close new clinical program opportunities., • Cultivate and manage trusted relationships with pharmacy benefit consultant groups, serving as a subject matter expert for our clinical programs., • Maintain a strong understanding of market dynamics, competitive landscape, and client needs to inform sales strategy., • Contribute to strategic client retention initiatives by aligning clinical programs with client goals., • Demonstrate strong analytical, presentation, and CRM skills to support sales execution and tracking., • Maintain a deep understanding of clinical programs, regulatory requirements (e.g., CMS, NCQA, URAC), and industry trends to effectively position our solutions., • Serve as a liaison between the field and internal product/clinical teams to ensure offerings remain competitive and relevant., • Support implementation handoffs to ensure smooth onboarding of new clients., • Provide market feedback to inform future product development and innovation., • Support general business needs and operations, as required., • All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Minimum Qualifications: • MBA degree and/or certification in sales or business, • 3+ years of applicable experience in a health plan or PBM, or healthcare sales and/or completion of a PGY1 Clinical Pharmacy Residency Program, Managed Care Residency or Fellowship with additional 2+ years of applicable experience, • Exceptional negotiation, presentation, and communication skills with the ability to articulate clinical value propositions to diverse audiences., • Experience engaging or partnering with pharmacy consultant firms, • Working knowledge of pharmacy benefit management, Medicare Part D, and commercial pharmacy benefits, • Ability to analyze data and market trends to inform sales strategy and client recommendations., • Proven track record of meeting or exceeding sales targets and successfully closing complex B2B deals., • Maintain an active, unrestricted pharmacy license in the state of residence, • Ability to balance multiple complex projects simultaneously with minimal direction, • Ability to travel up to 50% Preferred Qualifications: • PharmD, • Experience working with HEDIS, Stars and PQA pharmacy quality measures, • Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint, • Experience with Confluence, Jira, Tableau, • Highly detail-oriented and analytical Visa Sponsorship: Capital Rx does not provide sponsorship to any candidates. This includes, but is not limited to those that require H1-B, TN, OPT, etc. Candidates must have authorization to work in the US at the time of application and throughout employment. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Salary Range$90,000—$140,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at___.

Job DescriptionBenefits: • Competitive salary, • Paid time off Psychiatric Mental Health Nurse Practitioner (PMHNP) (Integrated Behavioral Health Family Practice) Job Summary We are seeking a Psychiatric Mental Health Nurse Practitioner (PMHNP) to join our family medicine practice as part of an integrated behavioral health model. This role focuses on the evaluation, diagnosis, and management of common psychiatric conditions in adolescents and adults, working collaboratively with primary care providers to deliver comprehensive, whole-person care. The ideal candidate is passionate about mental health access, collaborative care, and evidence-based treatment. Key Responsibilities Psychiatric Evaluation & Management • Conduct psychiatric assessments and diagnostic evaluations, • Diagnose and manage:, • Depression, • Anxiety disorders, • ADHD, • PTSD, • Adjustment disorders, • Provide medication management, including:, • Antidepressants, • Anxiolytics, • Mood stabilizers (within scope), • ADHD medications (per state law) Refer complex or severe psychiatric cases (e.g., schizophrenia, bipolar disorder, active suicidality) to specialty care as appropriate. Behavioral Health Screening & Follow-Up • Administer and interpret standardized tools:, • PHQ-2 / PHQ-9, • GAD-7, • ADHD screening tools, • Monitor treatment response and medication side effects, • Adjust treatment plans based on clinical progress Collaborative & Integrated Care • Work closely with family physicians, nurse practitioners, and care coordinators, • Participate in collaborative care planning, • Coordinate referrals to therapy, psychology, or psychiatry as needed, • Communicate clearly with primary care providers regarding treatment plans Patient Education & Support • Educate patients on:, • Mental health conditions, • Medication use and expectations, • Lifestyle and behavioral strategies, • Promote adherence and shared decision-making, • Provide trauma-informed, patient-centered care Documentation & Quality • Maintain accurate and timely documentation in the EMR, • Support quality measures and screenings (HEDIS, depression remission/follow-up), • Comply with state and federal regulations, including controlled substance prescribing Qualifications Required • Graduate degree from an accredited Nurse Practitioner program, • Board certification as a Psychiatric Mental Health Nurse Practitioner (PMHNP), • Active state NP license, • DEA license (or eligibility), • Eligible for insurance credentialing, • Strong knowledge of psychopharmacology Preferred • Experience in outpatient psychiatry or integrated primary care, • Comfort working in a collaborative, fast-paced practice, • Experience treating adolescents and adults, • Familiarity with collaborative care or primary care psychiatry models Work Environment & Schedule • Outpatient, office-based setting, • Integrated with family medicine, • Competitive compensation and benefits, • Supportive, team-based culture, • Opportunities for growth and leadership Compliance Statement This role is designed for a PMHNP practicing within the scope of psychiatric licensure and state regulations. The provider will collaborate with primary care and refer complex cases to specialty psychiatry when indicated. Why Join Our Practice • Integrated behavioral health model, • Strong primary care collaboration, • Emphasis on access, quality, and continuity of care, • Community-focused practice with supportive leadership

Job DescriptionBenefits: • Competitive salary, • Paid time off Job Summary We are seeking a Family Nurse Practitioner (FNP) to join our growing family medicine practice. This role will focus on the management of diabetes, hyperlipidemia, obesity, and other common metabolic/endocrine conditions within a primary care setting. The Nurse Practitioner will work collaboratively with physicians and the healthcare team to provide comprehensive, patient-centered care across the lifespan. This position is ideal for an NP with strong interest and experience in chronic disease management, preventive care, and patient education. Key Responsibilities Clinical Care • Diagnose, treat, and manage Type 1 and Type 2 diabetes, • Manage hyperlipidemia, metabolic syndrome, obesity, and insulin resistance, • Monitor and adjust medications including:, • Oral hypoglycemics, • Insulin regimens, • GLP-1 agonists, • Lipid-lowering therapies, • Interpret laboratory results (A1C, lipid panels, CMP, TSH, etc.), • Provide preventive care and routine primary care services, • Perform comprehensive and focused physical exams, • Identify patients requiring referral to endocrinology or other specialists Patient Education & Counseling • Educate patients on:, • Diabetes self-management, • Nutrition and lifestyle modification, • Medication adherence, • Weight management, • Provide counseling on cardiovascular risk reduction, • Support shared decision-making and goal setting Care Coordination & Quality • Participate in quality improvement initiatives (HEDIS, value-based care), • Ensure compliance with evidence-based clinical guidelines, • Document accurately and timely in the electronic medical record (EMR) Qualifications Required • Masters or Doctorate degree from an accredited Nurse Practitioner program, • Board certification as a Family Nurse Practitioner (FNP), • Active state NP license and DEA (or eligibility), • Eligible for credentialing with insurance payers, • Strong clinical skills in primary care and chronic disease management Preferred • Experience managing diabetes and lipid disorders, • Familiarity with insulin management and newer diabetes medications, • Interest in metabolic health and preventive cardiology, • Experience in outpatient primary care or internal medicine Work Environment & Schedule • Outpatient family medicine setting, • Collaborative, team-based practice, • Opportunities for professional growth and continuing education Compliance Statement This role practices within the scope of Family Nurse Practitioner licensure. The position does not represent board certification in endocrinology but includes a focused clinical role in managing common endocrine and metabolic conditions commonly treated in primary care. Why Join Our Practice • Supportive physician collaboration, • Emphasis on quality care and patient outcomes, • Stable, community-focused practice, • Opportunity to develop expertise in metabolic health

Job Description About Grace at Home Grace at Home is an innovative health and care company on a mission to eliminate barriers and to improve care in high-need, urban and rural communities. Grace at Home’s purpose is to every day improve the health and well-being of those who need care the most – in their homes and communities. Overview: The Advance Practice Practitioner will provide Home-Based Primary Care in patient homes or Assisted Living communities. They hold a panel of patients and are responsible for diagnosing, treating and managing their acute and chronic medical conditions with MD oversight. Integral to the primary care team, you will perform annual health assessments, complete post discharge visits, and deliver cost-effective, quality care to assigned patients. Working collaboratively across a multi-disciplinary team, you will contribute to the development, implementation, and on-going refinement of home health processes. Duties and responsibilities: Clinical • Performing comprehensive in-home assessments for identified patients of the practice and assisting the primary care team in better managing chronic diseases., • Reviewing current symptoms and identifying diagnosis to be used in care management and active medical management of treatment., • Completing physical examinations, medication reviews, vital checks, lab draws, wound care and depression screenings., • Communicating assessment findings that will be used to inform the PCP of potential gaps in care. Coaching • Answering team member questions, helping with team member concerns, and overseeing team member work for quality and guideline compliance., • Assisting and supporting market Medical Director/Clinical Leadership in reviewing advance practice providers’ (APP’s) charts for quality assurance and quality improvement purposes and provision of feedback to team members. This is in addition to chart review performed by the advance practice providers’ (APP’s) supervising physician, • Assisting and supporting market Medical Director/Clinical Leadership in providing virtual and in person consultation with team members during home visits, • Assisting market Medical Director/Clinical Leadership in providing feedback to APP’s regarding clinical performance and opportunities for improvement, • Providing encouragement to team members, including communicating team goals and identifying areas for new training or skill checks, • Actively updating team members on best practices and continuing expectations, • Assisting market Medical Director/Clinical Leadership in promoting team member achievement of company and market performance goals., • Program development and management, • Assisting market Medical Director/Clinical Leadership with the planning, organization, direction, and evaluation of health care services provided by the provider team in support of the clinical model., • Onboarding / training, • Assisting Management and medical directors with planning and execution of new team member training on as needed basis., • Training new team members on clinical processes and programs within individual’s area of expertise., • Providing new team members with additional coaching and mentorship during and following onboarding., • Providing ongoing education to team members on clinical processes and programs within individual’s area of expertise., • Utilization management, • Ability to travel within the market to provide care to patients in their home based on the needs of the business/market., • Highly relationship oriented and ability to passionately serve the aging and elderly population., • Ability to evaluate and treat complex chronic conditions in the home setting, • Positive attitude with a solution-oriented approach and a comfort working within ambiguity., • Ability to receive constructive feedback from other team members, market Medical Director, and Management and address opportunities for improvement., • Ability to deliver constructive feedback to team members and discuss improvement opportunities., • Open minded; willingness to try new ideas, consider different perspectives, and adapt to change., • Ability to make decisions and create solutions that consider patient, team member, and business needs. What will define success in this role? Be a clinical leader and work with all providers to: • Accuracy on risk capture, high quality metrics, gap closure rates, and HEDIS exclusion diagnoses., • High patient satisfaction and improved health status including reduced hospitalization and emergency department visits., • Thinking critically to address patient needs, providing the appropriate resources and follow-up care to improve stability., • Educating patients on topics such as disease process, medication, and compliance, • Complying with all HIPAA regulations and maintaining security of protected health information., • Creating a positive, supportive, trusting team environment., • Effectively onboard new hires so they can provide care independently in the home, • Education:, • Family Nurse Practitioner (FNP), Adult Nurse Practitioner with geriatric experience, Advance Practice Registered Nurse (APRN), or Physician Assistant (PA)., • Certification & Licensure: Board certified (American Association of Nurse Practitioners [AANP] or American Nurses Credentialing Center [ANCC]) and holds active state licensure in the state of practice., • Experience:, • 3+ years of clinical experience as an APRN / FNP / PA in the primary care or home care setting., • Working knowledge of chronic care management and various medication options, • Current DEA license/Prescriptive Authority post-hire in NY., • Experience in Family Medicine, Internal Medicine, Geriatrics, Palliative Care, or home care. Financial Well-being • Competitive Compensation: We offer competitive salaries to attract and retain the best talent., • Comprehensive Medical Plan: We proudly offer a comprehensive medical option with an employer contribution., • Dental & Vision Coverage: Maintain your oral and eye health with our employer-paid dental and vision plans via MetLife., • Employer-Paid Insurance: Life, Short-Term Disability (STD), and Long-Term Disability (LTD) insurance are provided at no cost to you., • Continuing Medical Education (CME) Allowance for Providers: Stay at the forefront of your field with our CME allowance., • Commuter Benefits: Save on your commute with our commuter benefits program. This position requires in-home, assisted living, and independent-living community-based work. The job requires frequent travel for patient visits in all types of weather conditions. Work may be performed in settings with conditioned air, artificial light, and an open workspace. In this position you will need an ability to travel frequently by car and/or public transportation, the ability to communicate with customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting or standing for extended periods is common. Must be able to receive ordinary information and to prepare or inspect documents. Lifting of up to 50 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business. Equal Opportunity & Reasonable Accommodation Statement Grace at Home is an Equal Opportunity Employer committed to creating an inclusive environment for all employees. We provide equal employment opportunities to all individuals regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable law. If you require a reasonable accommodation during the application or employment process, please indicate this in your application or speak with your recruiter during the hiring process.

Job Title: HEDIS/Quality Improvement Medical Records Collector Location: Columbus, OH or Central Ohio Area Only Duration: 9 to 18 months Shift: 8:00 AM - 5:00 PM (CST/EST) Position Type: Contract (Temp to Hire: No) Required Experience: 2+ years Job Overview: #### Healthcare is seeking a detail-orien

The HEDIS Nurse Auditor is responsible for conducting quality audits related to state audits, HEDIS measures, and quality-related complaints and referrals. Familiarity with HEDIS guidelines and URAC accreditation standards preferred.

As the Director of Quality Initiatives, you will play a critical role in ensuring the highest standards of care and operational efficiency. Lead the organization's healthcare quality program, including the healthcare quality strategic plan, facilitate monthly quality forum, stay current on HEDIS and

Quality Assurance/Review, Performance Improvement, HEDIS. Mother Baby RN experience is required. Disclosure: The hourly rates and/or salaries listed may or may not reflect total compensation packages including bonus and fringe benefits, etc.

Job Description Our client is an established, growing, national healthcare provider. We are seeking a motivated Field Healthcare Network Development Representative, to serve as the primary strategic liaison between our health care client and their contracted healthcare provider networks in Queens and the Bronx in the New York City metro area. The role is responsible for developing and driving high-level partnerships, cultivating executive-level relationships, and collaborating with clinicians to ensure the delivery of superior member care. This role is instrumental in developing network management strategies and launching strategic initiatives that produce measurable progress on performance improvement and value-based care. The ideal candidate will have 5+ years of relevant experience in Managed Care, Medical Group operations, Provider Relations, or Quality Improvement. Must have prior experience advising health care providers and physicians using data and metrics to improve performance. A valid driver’s license and ability to travel 30% – 50% (up to 4 days per week) to meet with health care providers in the boroughs of Queens / Bronx in New York City, New York is required. PRIMARY RESPONSIBILITIES INCLUDE: Strategic Provider Management • Performance Consulting: Conduct regular in-person sessions with physicians to analyze performance metrics, provide real-time operational support, and identify clinical improvement opportunities., • Value-Based Care (VBC) Advocacy: Lead initiatives to align providers with performance-based agreements that incentivize cost-efficiency, quality outcomes, and member health., • Strategic Planning: Evaluate provider data to develop and execute long-term improvement plans and present detailed Health Benefit Ratio (HBR) analyses during Joint Operating Committee (JOC) meetings. Data & Education • Actionable Analytics: Leverage data tools to track performance, offering health care providers actionable feedback to optimize care delivery and hit key performance targets., • Provider Education: Act as a subject matter expert on Value-Based Performance (VBP) tools, claims submission procedures, EDI solicitation, and web portal utilization. Operational Excellence & Leadership • Conflict Resolution: Investigate and resolve high dollar / high-volume claim issues and navigate complex internal / external roadblocks to create long-term operational efficiencies., • Mentorship: Serve as a lead for external representatives, providing coaching and training to ensure team-wide alignment with health plan standards., • Executive Influence: Build and maintain C-Suite relationships both internally and externally to influence innovation, provider retention, and member growth. CANDIDATE REQUIREMENTS INCLUDE: • Bachelor’s degree in Business, Health Care Management, or closely related field required; Master’s Degree (MPH, MHA, or MBA) is highly preferred., • 5+ years of relevant experience in Managed Care, Medical Group operations, Provider Relations, or Quality Improvement., • Demonstrated relationship-building skills and track record of conducting face-to-face, data-driven performance meetings with health care providers and physicians., • High proficiency in Healthcare Effectiveness Data and Information Set (HEDIS) / Quality measures, cost / utilization metrics, and project management within an Independent Physician Association (IPA) or health plan setting., • Excellent verbal, written, interpersonal and presentation communication skills and the ability to work as a trusted health care professional. Exceptional ability to synthesize complex clinical and financial issues and communicate to diverse audiences, from clinical staff to executive leadership., • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) for use in communication, presentation preparation and analyses & tracking., • Valid Driver’s License and ability to travel locally up to 4 days per week., • Key Competencies: Collaborative Work Style, Influencer, Proactive, Problem-Solver, Professional, Resourceful, Results-Focused, Solutions Focused, Self-Motivated, Strategic, Team-Player., • Legal authorization to work in the U.S. is required. The company will not sponsor individuals for employment visas for this job at this time. POSITION LOCATION AND TRAVEL REQUIREMENTS: Field-based role in New York, NY. Must be able to travel locally 30% - 50% (up to 4 days per week) in the boroughs of Queens / Bronx in the New York, NY metro area for meetings with providers and site visits. Minimal overnight travel required. TEAM RESPONSIBILITY: Serve as a key team member of the provider engagement team. Collaborate with internal team members and external health care providers. Mentor team members. KEY RELATIONSHIPS / STAKEHOLDERS: • Head of Provider Engagement, • Internal Team Members and Subject Matter Experts (SME's), • External Health Care Providers, Physicians and Health Care Network Representatives RELOCATION ELIGIBILITY: No relocation assistance provided. Local, qualified New York City metro area candidates will be given preference and priority. Qualified candidates willing to self-relocate to the New York City metro area will also be considered. COMPENSATION & BENEFITS INFORMATION: • Base Salary Range: $105,000 - $120,000, commensurate with experience and qualifications., • Variable Pay: Up to 8% annual results-based performance bonus., • Benefits Include: Health & Dental Insurance, Paid Time Off, 401-K with match, FSA, Company Paid Training, etc., • Company equipment to work remotely from filed or home will be provided. POSSIBLE COMPARABLE TITLES: • Clinical Partnership Representative / Associate / Specialist, • Healthcare Business Development Representative / Associate / Specialist, • Healthcare Network Performance Representative / Associate / Specialist, • Healthcare Network Operations Representative / Associate / Specialist, • Healthcare Provider Engagement Representative / Associate / Specialist, • Healthcare Provider Network Representative / Associate / Specialist, • Healthcare Provider Performance Representative / Associate / Specialist, • Healthcare Provider Relations Representative / Associate / Specialist, • Healthcare Provider Success Representative / Associate / Specialist, • Physician Liaison Representative / Associate / Specialist, • Physician Relations Representative / Associate / Specialist, • Strategic Healthcare Account Executive, • Value-Based Care (VBC) Representative / Associate / SpecialistCompany DescriptionTalent Solution Partners is a full-service Talent Acquisition and Solutions Firm. Our primary focus is the placement of senior-level professionals and executives for clients in Healthcare, Consumer Products, Business-to-Business Services and related industries. Visit us at: Solution Partners is a full-service Talent Acquisition and Solutions Firm. Our primary focus is the placement of senior-level professionals and executives for clients in Healthcare, Consumer Products, Business-to-Business Services and related industries.\r\n\r\nVisit us at:

Job Description The American Lung Association has an excellent opportunity for a Senior Director, Health Promotions. Working as a member of the Health Promotions department, you will join an outstanding group of professionals dedicated to our mission: to save lives by improving lung health and preventing lung disease through research, education, and advocacy. The Senior Director, Health Promotions role will direct, implement, and evaluate health systems change programs, related to Addressing the Burden of Childhood Asthma in New York State grant including the implementation of evidence-based strategies to expand the quality and availability of guidelines-based asthma control services in New York. This is a grant-funded position serving the State of New York, focusing primarily on Brooklyn, Queens, Manhattan, and the Bronx. This a 100% grant funded position. Location: New York City, New York • Lead the implementation, evaluation, and monitoring of evidence-based, quality improvement programs for the Addressing the Burden of Childhood Asthma in New York State grant. This includes establishing and managing work plan projects that address the needs of the high-risk population incorporating the Centers for Disease Control and Prevention EXHALE Technical Package., • Direct health systems change deliverables, and sure they are met or exceeded; engage with funder to ensure fiscal and management adherence., • Present program outcomes and disseminate surveillance and evaluation findings at statewide and national meetings as needed., • Lead health promotions team to ensure the dissemination and implementation of Project BREATHE New York to expand access to and quality of guidelines-based asthma care coordinated across settings; ensure onboarding requirements are met, adequate training is provided, and individual staff goals are met., • Facilitate clinical advisor meetings, guide creation of evidence based, provider education materials, facilitate provider trainings across NYS., • Assign work and keep on top of assignments to staff. Supervising staff to meet project deliverables, establish priorities, and evaluate performance., • Serve on regional and national workgroups and committees as requested; represent the Association as a member of community, civic and/or health coalitions and organizations related to the Association’s mission., • Responsible for suggesting new project ideas, concepts and direction., • Project manager in the development and administration of project budgets, monitoring expenses, and correcting significant variances to ensure conformance with approved budgets., • Responsible for maintaining existing funding levels by completing and exceeding project deliverables. Responsible for seeking and suggesting new funding sources., • Collaborate with outside partnerships, program director, and subordinate staff in order to complete job objectives., • Master’s degree and/or clinical degree preferred. Nursing, Public Administration, Public Policy Public Health, Health Promotion, or related field, with a minimum of seven to ten years of management-level programing experience required., • Experience in driving quality improvement efforts in clinical settings, including understanding electronic medical record systems, supporting interoperability amongst various data reporting platforms required., • Demonstrated background in clinical quality improvement methodologies and using electronic health record data to collect and report on asthma or other chronic disease quality measures (HEDIS, QARR, encounter data)., • Strong working knowledge of clinical care delivery in pediatric settings and/or direct experience supporting the translation of national clinical guidelines into quality clinical care., • Must be Asthma Educator Certified (AE-C) within one year of hire., • Must have excellent project, budget, and staff management skills, as well as a thorough understanding of strategic development; previous experience managing teams to success across multiple geographic areas preferred., • Demonstrated success in grant writing and grant management., • Must be a self-starter with excellent communication skills, both written and oral. Superb organization skills and attention to detail., • Strong ability to relate effectively and establish strong cooperative relationships with medical, technical, analytic and executive-level personnel., • Demonstrated people skills to manage a group of staff. Ability to achieve high level of performance where there are multiple job assignments and tasks., • Other duties as assigned within the job performance., • Must have a valid Driver’s license and your own reliable transportation with the ability to travel within assigned area (primarily Brooklyn, Queens, Manhattan, and the Bronx) 60% of the time for meetings and conferences, as well as the flexibility to work irregular hours, including evenings and weekends with some overnights required. Additionally, there will be occasional travel to other areas of New York State, as well as potentially to other states on an incidental basis., • Able to work with minimum direct supervision, make decisions, and take initiative., • Must be proficient in Microsoft Office, Microsoft Team and internet applications., • Ability to lift and carry 25 lbs. Benefits: The Lung Association offers a comprehensive benefits package including: • Paid Leave - 10 vacation days in the first year (15 days thereafter), 2 personal days and 15 sick days per year, as well as 12 company-paid holidays per year. We also offer Paid Parental Leave for eligible employees., • Insurance - Employees (and their eligible dependents) can enroll in our medical, dental, and vision plans, as well as voluntary plans for critical illness, accident, hospital indemnity, short-term disability and supplemental life/AD&D insurance. Employees will be enrolled in company-paid life/AD&D and long-term disability Insurance coverage. The American Lung Association is an equal opportunity employer. It is the policy of the American Lung Association to prohibit discrimination and harassment of any type and to provide equal employment opportunities to employees and applicants, without regard to their race, color, sex, sexual orientation, age, marital status, religion, national origin, alienage or citizenship status, genetic predisposition or carrier status, or physical and/or mental disabilities, veteran status, or any other status protected by law. Policy Statement It is the policy of the American Lung Association to prohibit discrimination and harassment of any type and to provide equal employment opportunities to employees and applicants, without regard to their race, color, sex, sexual orientation, age, marital status, religion, national origin, alienage or citizenship status, genetic predisposition or carrier status, or physical and/or mental disabilities, veteran status, or any other status protected by law. This policy applies in all employment actions including recruitment, hiring, promotions, transfers, corrective actions, terminations, compensation, benefits and training.

Job DescriptionDescription: Join a high-performing, mission-driven organization at the forefront of value-based care and quality performance. As Director of Quality and Provider Engagement, you will have a direct seat at the table for both strategy and operations, shaping the future of care for more than 350,000 lives. Role Overview: • The Director of Quality and Provider Engagement will collaborate closely with clinical and operational leadership to define strategy, identify and track key performance measures, and drive execution. You will oversee initiatives to increase member engagement, retention, and quality outcomes while delivering measurable financial results through value-based care. This is a senior, cross-functional role that blends lifecycle strategy, audience segmentation, and rigorous experimentation to continuously improve the member and provider experience. The position is intentionally balanced: approximately 50% hands-on operational involvement and 50% people leadership, including coaching and developing a high-performing team. The Director of Quality and Provider Engagement reports directly to the Chief Medical Officer. Why this role is unique? • Join one of the best-performing IPAs and ACOs in the region in quality and value-based care performance, recognized by both payers and provider groups as best in class., • Work alongside top professionals in value-based payment who are passionate about innovation, impact, and equity in care delivery., • Help drive performance for a panel of over 350,000 lives, with the ability to see your strategies translate into tangible clinical and financial outcomes., • Be part of a mid-size, nimble organization where decisions are made quickly, bureaucracy is limited, and your voice meaningfully shapes direction., • Sit at the same table as executive leadership for strategy and operations and collaborate daily with mission-driven talent across clinical, analytics, IT, and provider engagement. Responsibilities: • Lead and mentor two high-talent, highly engaged departments: Quality and Provider Engagement, ensuring tight alignment with the company’s vision for health care quality and value., • Develop and execute strategic plans to improve performance in CMS Star Ratings, HEDIS, Quality Rating System metrics, and other value-based programs (ACOs and payer-specific initiatives relating to quality)., • Provide leadership for strategic plan implementation, translating high-level goals into clear roadmaps, accountability structures, and measurable outcomes., • Drive regular interdisciplinary meetings to ensure quality initiatives are executed effectively, on time, and with clear ownership and follow-through., • Serve as operational leader and thought partner on quality, including strategy, process design, implementation, and continuous improvement, • Lead efforts to move the IPA to consistent 4–5 Star performance across key lines of business., • Represent Quality in internal and external meetings, clearly communicating performance, key initiatives, and outcomes to leadership, payers, and providers., • Build and deepen business relationships with providers participating in quality and value partnerships; proactively problem-solve and address provider concerns., • Partner with internal stakeholders to design and deliver provider education and training focused on quality improvement, documentation, and risk adjustment., • Collaborate with Information Technology to design and continuously enhance the Point-of-Care tools, incorporating feedback from providers, internal teams, and external stakeholders., • Lead digital transformation for the quality function by reducing manual reporting and championing technology-enabled workflows, analytics, and automation., • Partner with IT, Data, and Accounting to manage the distribution of quality incentives, risk adjustment earnings, and shared savings., • Own the strategy and execution of programs aimed at increasing member quality, engagement, and retention across the network.Requirements:, • Bachelor’s degree in Healthcare, Health Administration, Public Health, or a related field required; Master’s degree preferred., • 10+ years of experience in health plans, IPAs, ACOs, or similar environments with direct exposure and responsibilities to HEDIS, Star Ratings and provider quality performance., • Demonstrated success leading teams and initiatives that improved quality and provider engagement in a value-based care environment., • Strong leadership presence with the ability to interface confidently with senior executives, physicians, and external partners., • Proven track record of developing and mentoring high-performing teams and fostering a culture of accountability, collaboration, and continuous improvement., • Excellent communication skills—comfortable presenting to boards, executives, payers, and provider groups, and translating complex data into clear, actionable narratives., • Strong analytical and critical thinking skills, with the ability to use data to prioritize, problem-solve, and drive decision-making., • Deep knowledge of CMS Quality Ratings, Star Ratings, NCQA measures and methodologies. ., • Experience designing and delivering provider education programs tied to quality and documentation performance., • Competitive base salary in the range of 120,000–150,000, commensurate with experience and impact., • Comprehensive health benefits, including medical, vision, and dental coverage., • Company-paid life insurance., • 401(k) retirement plan with a 6% corporate match., • Generous Paid Time Off and 13 paid holidays.

Job DescriptionDescription: The primary function of the HEDIS Retriever - Seasonal is to conduct onsite abstraction of services from medical charts in compliance with HEDIS/QARR, Medicare Advantage Star measure specifications. This position will be an integral part of the annual Medical Record Review project required to report HEDIS and QARR measures to the NYS Department of Health and Centers for Medicare & Medicaid Services (CMS). The position requires the ability to travel within the five boroughs daily. Scope Of Role and Responsibilities: • Maintain knoowledge of medical record review and EMR systems, • Maintain up to date knowledge of HEDIS, QARR and STAR specifications., • Proficiency in MS Office applications, scanning and accurate Data entry into our systems, • Distibute requests for records and schedules appointments with provideroffices to ensure timely completion of duties to meet internaland regulatory standards and requirements., • Perform abstractions via EMR, in house paper medical records, on- site provider visits to collectdocumentationof easure complaince., • High School/GED with a minimum of two yeards HEDIS review experience. Clinical background preferred ( Medical Assistant, Nursing Assistant, Health Educator, LPN, RN, LMSW, or LCSW), • Experience with medical record working on HEDIS/QARR in a managed care, health plan and provider office setting., • Proficient in Microsoft Office applications including Work, Excel, PowerPoint and Access.

Job DescriptionCardiology Nurse Practitioner/ Physician Assistant Location: New York Schedule: Full-Time (5 days per week) Salary: $150,000 - $200,000 About Infinite Medical P.C. Infinite Medical P.C. is a nationwide network of advanced practice providers and specialty clinicians committed to delivering high-quality, proactive care directly to residents in skilled nursing and long-term care facilities. Our partnership with MedElite Healthcare Management Group empowers us to focus on what matters most: providing compassionate, personalized care that meets the unique needs of each resident. Together, we champion continuous innovation and collaboration in our shared mission to redefine senior care across the country. Job Summary We are seeking a friendly and compassionate Cardiology Nurse Practitioner/Physician Assistant or a New Graduate Cardio Physician (MD) to join our team. As a Cardiology Nurse Practitioner/Physician Assistant, you will play a crucial role in providing comprehensive care to patients with heart-related conditions. This is an exciting opportunity to make a difference in the lives of patients while working alongside a dedicated team of healthcare professionals. . Responsibilities • Perform comprehensive patient assessments, including physical examinations, medical histories, and diagnostic tests, • Collaborate with cardiologists to develop and implement treatment plans for patients with cardiovascular conditions, • Administer medications, monitor patient responses, and adjust treatment plans as necessary, • Conduct cardiac stress tests, electrocardiograms (EKGs), and other diagnostic procedures, • Educate patients and their families about cardiovascular health, preventive measures, and the importance of medication adherence, • Provide counseling and emotional support to patients and their families, • Knowledge of CMS Regulations and NCQA HEDIS Guidelines, • Document accurate medical records to ensure compliance with OSHA and Government regulations and perform duties in accordance with site quality and safety systems, • Collaborate with the interdisciplinary team, • Analyze and organize the care of critically complex patientsRequirements, • Minimum 6 months of experience in long-term care or a skilled nursing facility, • Active and unrestricted Nurse Practitioner, Physician Assistant, or Physician license, • New Graduate Cardio Physicians welcome to apply, • DEA License, • CPR BCLS/BLS certified, • Must hold a Master's Degree in Nursing, • Completed a degree from an accredited Nurse Practitioner program, • Preferred experience in cardiology: training provided, • Preferred experience in Documenting EMR (Sigma, Visual, PCC, etc.): training provided, • Preferred LTC experience, • Must have great organizational and time management skills., • Competitive salary: $150,000 - $200,000, • Health, • Vision, • Dental, • 401K, • Company- Sponsored Life Insurance, • Student Loan Repayment Program, • Paid subscription to UpToDate, • Paid Time Off, • Malpractice InsuranceWhy Work With Us?, • Make a meaningful impact on the lives of seniors, • Work in a collaborative, mission-driven environment The above-noted job description is not intended to describe, in detail, the multitude of tasks that may be assigned but rather to give the applicant a general sense of the responsibilities and expectations of this position. As the nature of business demands change so, too, may the essential functions of the position. Ready to Make a Difference? Apply today and help us deliver compassionate, personalized care where it matters most.

Job Description Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Maven's award-winning digital programs provide clinical, emotional, and financial support all in one platform, spanning fertility & family building, maternity & newborn care, parenting & pediatrics, and menopause & midlife. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes, reduce healthcare costs, and provide equity in benefits programs. Recognized for innovation and industry leadership, Maven has been named to the Time 100 Most Influential Companies, CNBC Disruptor 50, Fast Company Most Innovative Companies, and FORTUNE Best Places to Work. Founded in 2014 by CEO Kate Ryder, Maven has raised more than $425 million in funding from top healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. To learn more about Maven, visit us at mavenclinic.com. An award-winning culture working towards an important mission – Maven Clinic is a recipient of over 30 workplace and innovation awards, including: • Fortune Change the World (2024), • CNBC Disruptor 50 List (2022, 2023, 2024), • Fortune Best Workplaces for Millennials (2024), • Fortune Best Workplaces in Health Care (2024), • TIME 100 Most Influential Companies (2023), • Fast Company Most Innovative Companies (2020, 2023), • Built In Best Places to Work (2023), • Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024), • Great Place to Work certified (2020, 2021, 2022, 2023, 2024), • Fast Company Best Workplaces for Innovators (2022) As an Clinical Outcomes Analyst at Maven, you will: • Help design rigorous retrospective and prospective analysis plans to evaluate Maven's impact on health outcomes and ROI, • Quantitatively analyze data for projects assessing Maven's influence on health outcomes, healthcare experience, and ROI using statistical analysis software, • Extract insights on a diverse set of clinical and operational outcomes on our internal data platform in Looker / SQL, • Participate in retrospective evaluations of Maven's impact for existing clients, including analysis of healthcare claims and self-reported platform data, study design, and communication of results in Powerpoint and / or Word, • Collaborate with the Product team on analyses to inform clinical programming and product design, • Perform market research to help Maven build internal analytics capabilities or evaluate potential partnerships, • A bachelor's degree with 2-3 years of healthcare‑industry or consulting experience or a master's or PhD in a relevant field, • Experience working with and manipulating healthcare claims (medical & Rx) to answer complex questions about outcomes and utilization patterns, • Comfort with rapid, accurate data exploration, in SQL / Looker. A live SQL exercise will be conducted as part of the interview process, • Strong ability to use and curiosity regarding AI and how it can be used to make our work faster and Maven's product better for our members, • A profile that balances technical abilities to answer questions through data manipulation and strong written and verbal communication skills, including "translation" with team members and clients of varying technical abilities, • A sense of flexibility and prioritization in juggling both long-term, strategic projects and ad hoc, urgent requests as needed in a fast-paced startup environment, • Solid SQL or Python for large‑scale data analysis, with a bonus of R for heavier statistics, • Data‑visualization tools (Looker a plus), • Experience in client-facing or external stakeholder-facing roles, • Comfort with presenting results in an external facing setting (e.g., client meetings, scientific forums, etc.), • Financial modeling and/or applied statistics, • Familiarity with industry financial models (e.g., PMPM, risk adjustment, HEDIS/Stars), • Familiarity with value‑based‑care payment models (bundles, shared savings) This role requires active work authorization in the US. At Maven we believe that a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you do not have experience in all of the areas detailed above, we hope that you will share your unique background with us in your application and how it can be additive to our teams. Benefits That Work For You Our benefits are designed to support your health, well-being and career development, helping you thrive both personally and professionally. We remain focused on providing a competitive benefits package for our employees. On top of standards such as employer-covered health, dental, and insurance plan options, we offer an inclusive approach to benefits: • Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning and pediatrics., • Whole-self care through wellness partnerships, • Hybrid work, in office meals, and work together days, • 16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+), • Annual professional development stipend and access to a personal career coach through Maven for Mavens Maven is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Maven is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Maven Clinic interview requests and job offers only originate from an @mavenclinic.com email address (e.g ). Maven Clinic will never ask for sensitive information to be delivered over email or phone. If you receive a scam issue or a security issue involving Maven Clinic please notify us at: . For general and additional inquiries, please contact us at .

BI tools Experience analyzing risk adjustment data for trends, disease/diagnosis prevalence and hierarchy Experience managing data flows for chart retrieval, RA coding, HEDIS abstraction and quality Ability to build, architect and deliver robust customer facing and internal reports Experience in bui

Job Description POSITION SUMMARY: The Primary Care Provider delivers high-quality, compassionate, comprehensive primary care services at Joseph P. Addabbo Family Health Center (JPAFHC). This role emphasizes preventive care, chronic disease management, and patient education, with a focus on serving medically underserved and culturally diverse populations. The PCP works as part of an integrated, multidisciplinary care team to improve health outcomes and advance health equity. RESPONSIBILITIES: Clinical Care · Deliver comprehensive, patient-focused primary care for adults. · Perform comprehensive assessments, diagnosis, treatment, and follow-up in accordance with evidence-based guidelines. · Manage acute and chronic medical conditions, including hypertension, diabetes, asthma, COPD, and behavioral health concerns. · Conduct preventive care services such as annual physicals, screenings, immunizations, and health education. · Order and interpret diagnostic tests, labs, imaging, and specialty referrals as appropriate. · Deliver care both in-person and via telehealth as needed. Care Coordination & Team Collaboration · Work collaboratively with nurses, medical assistants, behavioral health providers, case managers, and dental providers. · Participate in team huddles, care planning, and quality improvement activities. · Coordinate care transitions, referrals, and follow-up services to ensure continuity of care. · Maintain effective communication with specialty providers, hospitals, and community resources. · All providers will share responsibility for on-call coverage, ensuring patient care needs are met outside regular clinic hours. Compliance & Documentation · Document all encounters in the electronic health record (EHR) accurately, thoroughly, and in a timely manner. · Adhere to federal and state regulatory requirements, including HRSA, UDS, OSHA, and infection control standards. · Comply with FQHC-specific requirements such as sliding fee scale documentation, enabling services referrals, and quality reporting. Quality & Performance Improvement • Participate in quality initiatives such as PCMH, meaningful use, HEDIS/UDS measures, and population health programs., • Use evidence-based practices to contribute to the improvement of clinical workflows., • Follow protocols that support value-based care and improved patient outcomes., • Required to take part in peer review activities to ensure adherence to clinical standards and best practices. Community & Mission Engagement • Support the mission and values of the JPAFHC to provide accessible, equitable, and culturally competent care., • Participate in outreach, health education events, and collaborations with community partners as needed. COMPENSATION AND BENEFITS • Competitive salary with eligibility for productivity or quality incentives., • Comprehensive benefits package including medical, dental, and vision., • Automatic 1% payroll deduction into 403(b) retirement account, • Paid time off, CME days and stipend., • Eligibility for NHSC and state loan repayment programs. MINIMUM QUALIFICATIONS: Required · Licensed Physician (MD/DO), in New York State · Board-certified or board-eligible in Family Medicine, Internal Medicine. · Current DEA registration: ability to obtain X-Waiver/MAT certification if required. · Current BLS/CPR certification. · Experience or strong interest in working with underserved populations. Preferred · Experience in an FQHC or community health setting. · Familiarity with value-based care, population health, and trauma-informed care. · Bilingual skills (e.g., Spanish) highly desirable. · Experience with eClinicalWorks EHR systems Work Environment & Physical Requirements · Outpatient clinic setting with possible satellite site coverage. · Must be able to work extended hours or occasional weekends as needed. · Ability to sit, stand, and walk for extended periods and lift up to 25 lbs occasionally.

Job Description Duties: Maintain knowledge of medical record review and EMR systems. Maintain up-to-date knowledge of HEDIS, QARR and Star specifications Distribute requests for records and schedules appointments with provider offices ensure timely completion of duties meet internal and regulatory standards and requirements. Perform clinical audits via EMR, in-house paper medical records, on-site provider visits measure compliance with preventive health guidelines and measure effectiveness of quality improvement initiatives. Identify, track and report variation from standards of care by audit of core operations, patient care processes and medical record documentation. Designs interventions drive improvement and minimize variation from standards of care. Data enter accurate and timely clinical quality findings in the appropriate system(s) in accordance with established documentation standards for Metro Plus Health Plan ensure integrity of member services provided over the continuum of care and over time. Assist in implementation of quality improvement activities as directed by Quality Management programming needs. Support interdepartmental and internal teams focused on process improvement projects and outcomes. Provide educational support physicians and staff ensure process improvement and increase member satisfaction, member retention, continuity of care and drive HEDIS and QARR improvement activities. Facilitate retrieval of medical record documentation and work with provider group(s) and in-field navigators retrieve electronic and paper records that supports HEDIS/QARR. Records findings of patient encounters include patient identifiers, relevant information and results in database. Participate in the annual HEDIS and QARR hybrid medical record review project: Work with provider offices facilitate request and review of charts Supports temporary staff in the review of medical records (electronic and paper-based) Serve as a final reviewer of HEDIS and QARR records Skills: Clinical background: Health Educator, RN, LPN, RN, LMSW or LCSW, Foreign Medical Graduate (FMG) with a minimum of three years relevant work experience. Experience with medical record review working on HEDIS/QARR in a managed care or health plan setting. 3 5 years in Quality Improvement in a health care and/or Managed Care setting strongly preferred. Ability travel within the Metro Plus service area. Knowledge of HEDIS and QARR specifications. Experience using EMR systems, e.g. EPIC, Quadramed. Proficient in Microsoft Office applications including Word, Excel, PowerPoint and Access. Knowledge of ICD-10 and CPT codes preferred. Ability proficiently read and interpret medical records; Ability measure compliance and identify deficiencies in chart documentation against standards. Education: High School/GED with a minimum of years HEDIS review experience. Clinical background preferred (Medical Assistant, Nursing Assistant, Health Educator, LPN, RN, LMSW or LCSW. Experience with medical record review working on HEDIS/QARR in a managed care, health plan or provider office setting. Proficient in Microsoft Office applications including Word, Excel, PowerPoint and Access. Schedule Notes: Shift Time: 9:00AM -5:00PM In person/Hybrid: Field Job Requirements: Maintain knowledge of medical record review and EMR systems. Maintain up-to-date knowledge of HEDIS, QARR and Star specifications Distribute requests for records and schedules appointments with provider offices ensure timely completion of duties meet internal and regulatory standards and requirements. Perform clinical audits via EMR, in-house paper medical records, on-site provider visits collect documentation of measure compliance. Data enter accurate and timely findings in the appropriate system(s) in accordance with established documentation standards for Metro Plus Health Plan ensure integrity of member services provided over the continuum of care and over time.

RWJBarnabas Health, in partnership with Montgomery Medical Associates, is seeking an Physician Assistant to join a collaborative practice serving Somerset County, NJ.They will deliver high-quality primary care services in a small, community-based family practice with additional coverage at a nearby

Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of between $25/hr.There is no payment required in order to apply or to work as an In-Home Usage Tester.You do

Now hiring Certified Nursing Assistants (CNA).Join a fantastic company and facility.Experience a great environment led by an engaged management team!.Part Time, PD and Full Time shifts available.Job Description for Certified Nursing Assistants (CNAs):.A Certified Nursing Assistant's (CNA) main role

Now hiring Certified Nursing Assistants (CNA).Join a fantastic company and facility.Experience a great environment led by an engaged management team!.Full time, Part time, Per Diem.Job Description for Certified Nursing Assistants (CNAs):.A Certified Nursing Assistant's (CNA) main role is to:.Provide

About Us One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable.But this isn’t your average doctor’s office.We’re on a mission to transform healthcare, which means improving the experience for everyone involve

About Us One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable.But this isn’t your average doctor’s office.We’re on a mission to transform healthcare, which means improving the experience for everyone involv

Mobile Medical Assistant / Phlebotomist.IQVIA's In-Home Clinical Solutions team seeks a qualified and dedicated Mobile Medical Assistant / Phlebotomist to support patient care by delivering in-home diagnostic services.This per diem role involves traveling to patient residences to perform clinical se

Now Hiring | Medical Assistant for Premier Hair Restoration Practice in New York City.Do you want to work in an exciting, growing industry? The aesthetic medicine industry continues to expand, as more and more people are seeking ways to improve their appearance and confidence.Bosley, the world's lea

Seeking participants for Focus Group and market research studies.Work part-time from home and earn up to $750 per week.Register to see if you are eligible.Data Entry experience not required.Remote Work From Home Data Entry Clerk - Part Time Market Research Panelists Our company is seeking individual

An experienced medical assistant, who under the supervision of the dtc clinical staff will perform venipuncture and finger blood, including drawing, capping, and labeling of blood specimens, as well as performing ekgs.

Define the Patient Care Experience at One of New York's Bests Hospital.Be the Face of Patient Excellence and Quality Customer Service.Make a lasting first impression at the NewYork-Presbyterian AIM Clinic - meeting and greeting patients and family members in need of a compassionate ear and calm dire

At New York Cancer & Blood Specialists (NYCBS), we are dedicated to making a difference in the lives of our patients, their families, and our communities.Our passionate team of expert oncologists, hematologists, and healthcare professionals work together to provide world-class cancer care close to h

Certified Medical Assistant Cardiology And Gastro.Optum NY, is seeking a Certified Medical Assistant Cardiology and Gastro to join our team in New York, NY.Optum is a clinician-led care organization that is changing the way clinicians work and live.As a member of the Optum Care Delivery team, you'll

Provides clinical office support to physicians and surgeons and performs patient care and administrative duties necessary to deliver quality patient care.Fulfills patient care responsibilities as assigned which may include: performing venipuncture and/or EKGs, checking schedules and organizing patie

Medical Assistant (Temp) - Manhattan.NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation.News & World Report recently placed nine of its c

Medical Assistant Bilingual (Spanish / English) Preferred.We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience.At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourse

Optum NY is seeking a Medical Assistant to join our team in New York, NY.Optum is a clinician-led care organization that is changing the way clinicians work and live.As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.At Optum,

Are you an experienced Medical Assistant seeking a rewarding role in an Endocrinology Practice serving patients in nursing homes? Join our team! Position: Medical Assistant Location: Multiple Locations around NYC Responsibilities: - Drive to different Nursing Homes and perform a QuantaFlo test - Mai