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Job DescriptionHealthPlus Staffing is assisting a well established organization with their search for a Nurse Practitioner to join their team in Harlem, NY. With over 35 clinics and over half a million patients across the 5 boroughs and Long Island, the growth potential is exponential. Job Description: • Location: Harlem, NY, • Position: Nurse Practitioner, • Specialty: Primary Care, • Structure: Outpatient (No call), • Start: 30-60 days Days, • Schedule: Full-Time (40 hours), • Duties: Consultations, Follow up, Physical exams, • EMR: Epic, • Support: Full Office Staff and APP, • Compensation: 120-145K, • Benefits: Full Package Qualifications:, • Unrestricted NY license, • BC/BE as a Nurse Practitioner, • Active DEA registration, • Must possess active Medicare/Medicaid Enrollment or be eligible to enrollIf interested in this position please apply immediately and someone will be in contact within 24 hours of submission.

Job Description JOB SUMMARY: As a member of a multidisciplinary treatment team, the Psychiatric Nurse Practitioner provides advanced clinical psychiatric nursing care to referred clients. Performs psychiatric evaluations and psychiatric medication management for clients in ongoing treatment. Ensures accuracy of diagnosis and appropriate pharmacologic interventions and supports appropriate multidisciplinary interventions. Provides clinical leadership within the team to recommend program placement and coordinate treatment planning. EESENTIAL JOB FUNCTIONS: • Performs comprehensive, diagnostic psychiatric evaluations and provides ongoing medication management and treatment for clients., • Submits health care plan and goals of individual clients for periodic review and evaluation with the psychiatrist., • May refer clients to psychiatrist for consultation or specialized health resources for treatment., • Cultivates clinical staff quality of care through consultation with and education of interdisciplinary personnel, clients, and their significant others., • Performs crisis intervention using verbal and nonverbal techniques., • May have on-call responsibilities and provide periodic clinical coverage for colleagues., • Immediately reports serious incidents, serious incident allegations, incidents, or sensitive situations to supervisors, • Attends regularly scheduled clinical meetings and supervision., • Attends professional development activities and training., • May conduct workshops for clients and staff on health-related issues to include health maintenance, medications, and medication administration., • May precept nursing students and nurse practitioner students., • May be assigned as a participant or facilitator of agency committee(s)., • Ability to effectively respond to and manage behavioral health emergencies, • Ability to effectively communicate both orally and in writing, including communication by electronic means., • Knowledge of emergency psychiatric treatments and interventions., • Knowledge of teaching and consultation techniques., • Knowledge of the Agency's policies and procedures., • Knowledge of cultural, ethnic, and linguistic needs of clients in a culturally competent manner. Master’s or Doctorate degree in nursing from an accredited nurse practitioner program, and currently licensed in New York State as a Psychiatric Mental Health Nurse Practitioner (PMHNP). Current DEA certification. ANCC certification is an asset. Two years’ experience with individuals suffering from co-occurring severe psychiatric conditions and substance use disorders. Must be eligible for full and unconditional participation in the Medicaid and Medicare programs. May be required to possess a valid NYS driving license and a clear driving record. Continued employment is based on the ability to maintain professional licensure and accreditation, and participation in the Medicaid and Medicare programs.

Job Description Psychiatric Mental Health Nurse Practitioner (PMHNP) - Bronx, NY (#1669) • Medical, Dental, and Vision insurance, • Flexible Spending Account, • Paid Time Off, • Retirement Savings, • Commuter Benefits program About Impact Recruiting Solutions: Impact Recruiting Solutions is a dedicated recruitment partner connecting healthcare professionals with rewarding opportunities. We collaborate with hospitals, clinics, and multi-specialty facilities to match skilled individuals with roles that align with their expertise and career aspirations. Position Overview: We are seeking a dedicated Psychiatric Mental Health Nurse Practitioner (PMHNP) for a hybrid role with a multi-specialty practice in the Bronx. This position offers the flexibility of a hybrid schedule, allowing you to balance on-site patient care with remote work. Requirements • Education: Master's or Doctoral degree in Nursing from an accredited Nursing program., • Licensure:, • Active and unrestricted NP license. Active DEA registration., • Active Medicaid provider status., • Experience: Minimum of 2 years of experience as a Psychiatric Mental Health Nurse Practitioner (PMHNP)., • Language: Spanish preferred., • Competitive Compensation: Earn a competitive annual salary of $135,000 - $145,000/yr., • Comprehensive Benefits:, • Medical, Dental, and Vision insurance, • Flexible Spending Account, • Paid Time Off, • Retirement Savings, • Commuter Benefits program, • Visa Sponsorship opportunities, • Malpractice insurance coverage, • Loan repayment, • Flexible schedules, • Stable Employment, • Exclusive 20% Discount Tuition Reduction with local College, • Work Schedule:, • Full-time or Part-time options available., • Hybrid schedule (on-site once a week)., • Hybrid Work Model: Enjoy the flexibility of a hybrid schedule, requiring on-site presence once per week., • Professional Growth: Gain valuable experience in a collaborative, innovative, and supportive environment., • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes.

Job DescriptionAthenaPsych is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges. We specialize in individual and group psychotherapy for clients with a focus on trauma-informed care. We are dedicated to improving the quality and accessibility of mental health care for all, especially individuals from underserved communities. Here at AthenaPsych, we pride ourselves on hiring a diverse group of mental health clinicians and staff who are passionate and dedicated to improving our client’s overall emotional well-being. We provide both in-person and telehealth services for our clients and offer a competitive fee-for-service compensation plan and amazing benefits to our staff. Are You a Good Fit For Us?We are currently seeking an experienced, professional, and compassionate Psychiatric Nurse Practitioner to join our growing organization. Flexible hours are provided with the need of some evening hours, in-person and telehealth sessions. This position will work in collaboration with our Psychiatrist on staff. Our mental health clinic is located at 33 W 60th St 6th floor New York, NY.Responsibilities • Conduct psychiatric evaluations for all Athena clients (children and adults), • Conduct ongoing medication management when needed, • Complete all required documentation by a given deadline and in compliance with program and state regulations, • Ensures all clinical notes and client information are updated and accurate within the current EHR system, • Provide conflict resolution and crisis intervention when needed, • Work in collaboration with administrative staff to ensure client needs are successfully met, • Ability to commute between sites when neededQualifications, • Master's Degree in Nursing from an accredited school, • Bilingual in English and Spanish prefered, • Must be certified with the Drug Enforcement Administration in order to prescribe medication to clients, • Must be licensed in New York State, • Experience working with Medicaid/Medicare Clients is a plus

Job DescriptionAthenaPsych is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges. We specialize in individual and group psychotherapy for clients with a focus on trauma-informed care. We are dedicated to improving the quality and accessibility of mental health care for all, especially individuals from underserved communities. Here at AthenaPsych, we pride ourselves on hiring a diverse group of mental health clinicians and staff who are passionate and dedicated to improving our client’s overall emotional well-being. We provide both in-person and telehealth services for our clients and offer a competitive fee-for-service compensation plan and amazing benefits to our staff. Are You a Good Fit For Us?We are currently seeking an experienced, professional, and compassionate Psychiatric Nurse Practitioner to join our growing organization. Flexible hours are provided with the need of some evening hours, in-person and telehealth sessions. This position will work in collaboration with our Psychiatrist on staff. Our mental health clinic is located at 33 W 60th St 6th floor New York, NY.Responsibilities • Conduct psychiatric evaluations for all Athena clients (children and adults), • Conduct ongoing medication management when needed, • Complete all required documentation by a given deadline and in compliance with program and state regulations, • Ensures all clinical notes and client information are updated and accurate within the current EHR system, • Provide conflict resolution and crisis intervention when needed, • Work in collaboration with administrative staff to ensure client needs are successfully met, • Ability to commute between sites when neededQualifications, • Master's Degree in Nursing from an accredited school, • Bilingual in English and Spanish prefered, • Must be certified with the Drug Enforcement Administration in order to prescribe medication to clients, • Must be licensed in New York State, • Experience working with Medicaid/Medicare Clients is a plus

Job Description Educational Alliance brings together and partners with diverse communities in Lower Manhattan, offering individuals and families high-quality, multi-generational programs and services that enhance their well-being and socioeconomic opportunities. We are a place where everyone is welcome and where progress is powered one relationship at a time. We are proud of our legacy as a Jewish organization, and we provide high-quality, transformational services and programs to all New Yorkers through our network of community centers on Manhattan’s Lower East Side and East Village. As we have for 130 years, we offer best-in-class programming–now across 15 sites—focusing on a mix of education, health and wellness, arts and culture, and civic engagement The Center for Recovery and Wellness takes a holistic, strengths-based approach to recovery and wellness that responds to the distinct needs of each individual. Programs include residential and outpatient addiction treatment, recovery services, prevention education, and community programming. CRW offers culturally competent, evidence-based programs and services that strengthen individuals and communities, enhance resiliency, and foster lasting recovery. We are seeking a full time Psychiatric Nurse Practitioner (PMHNP) to provide psychiatric evaluation, medication management, and clinical consultaion across both the OASAS 820 residential programs and the OASAS 822 outpatient program. Working in close collaboration with the Medical Director and multidisciplinary teams, the PMHNP supports integrated trauma-informed care for adults with substance use disorders and co-occurring mental health needs. RESPONSIBILITIES • Conduct comprehensive psychiatric evaluations, including history and mental status examinations, for residential and outpatient clients, • Diagnose psychiatric conditions and establish individualized treatment plans, • Provide ongoing psychopharmacological treatment and medication management, including MAT (e.g., buprenorphine, naltrexone) where appropriate, • Provide and/or oversee administration of long‑acting injectable medications as appropriate, • Monitor medication efficacy, adherence, and side effects, • Collaborate with residential and outpatient treatment teams to support integrated care, • Provide clinical psychiatric consultation to program staff, • Complete accurate and timely documentation in the Electronic Health Record (EHR)., • Consult the NYS Prescription Monitoring Program (IStop) when prescribing controlled substances., • Provide psychoeducation to clients regarding diagnoses, medications, and health-promoting behaviors, • Contribute to program development and clinical best practices across both levels of care, • Perform other duties as assigned by the Medical Director. REQUIRED QUALIFICATIONS • Master’s or Doctoral degree in Nursing from an accredited Nurse Practitioner program, • Active New York State Registered Nurse (RN) and Nurse Practitioner (NP) licenses, • National certification as a Psychiatric-Mental Health Nurse Practitioner (PMHNP‑BC), • Valid DEA registration and NPI number, • Enrollment (or eligibility to enroll) as a Medicaid and Medicare provider, • Current Basic Life Support (BLS) certification, • Strong assessment, diagnostic, and psychopharmacology skills, • Experience working with individuals with co-occurring substance use and mental health disorders, • Strong communication, organizational, and interpersonal skills, • Ability to maintain confidentiality and comply with regulatory and ethical standards, • Experience in OASAS-regulated programs, • Experience with MAT (e.g., buprenorphine, naltrexone), • Experience working in residential or community-based behavioral health programs BENEFITS • Generous PTO policy, • Competitive Salary, • Medical & Dental Insurance, • Pension Plan, • 403b Retirement Plans, • Discount Perks for Movies, Broadway Shows, and Amusement Parks, Etc., • Free Gym Membership to our MCC FITNESS & 14TH ST Y Gym, • Discounts to programs at Educational Alliance Limitations and Disclaimer The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required for the position EEO Info Educational Alliance is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, marital status, disability status, veteran status, or any other characteristic protected by applicable federal, state, or local law. For further information about Educational Alliance, please visit .

Job Description Psychiatric Mental Health Nurse Practitioner (PMHNP) / Hybrid - Bronx, NY (#1669) • Location: Bronx, New York, • Employment Type: Full-time or Part-time (Hybrid schedule (on-site once a week)., • Salary: $135,000 - $145,000/yr About Impact Recruiting Solutions: Impact Recruiting Solutions is a dedicated recruitment partner connecting healthcare professionals with rewarding opportunities. We collaborate with hospitals, clinics, and multi-specialty facilities to match skilled individuals with roles that align with their expertise and career aspirations. Position Overview: We are seeking a dedicated Psychiatric Mental Health Nurse Practitioner (PMHNP) for a hybrid role with a multi-specialty practice in the Bronx. This position offers the flexibility of a hybrid schedule, allowing you to balance on-site patient care with remote work. Why Join Us? • Work Schedule:, • Full-time or Part-time options available., • Hybrid schedule (on-site once a week)., • Hybrid Work Model: Enjoy the flexibility of a hybrid schedule, requiring on-site presence once per week., • Professional Growth: Gain valuable experience in a collaborative, innovative, and supportive environment., • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes. Key Responsibilities: • Conduct comprehensive psychiatric evaluations and assessments, including diagnosis of mental health and substance use disorders., • Develop, implement, and evaluate individualized treatment plans in collaboration with patients and their families., • Provide psychopharmacological evaluation and medication management, including prescription of psychotropic medications., • Utilize therapeutic communication to provide psychotherapy and counseling to individuals across the lifespan., • Order and interpret diagnostic tests and laboratory results as needed to support diagnosis and treatment., • Maintain accurate, timely, and confidential electronic medical records in compliance with state and federal regulations., • Collaborate effectively with physicians, therapists, social workers, and other members of the multidisciplinary care team., • Provide patient and family education regarding diagnosis, treatment options, and mental health wellness., • Participate in case conferences, clinical supervision, and continuing education to ensure the highest standard of care. Impact Recruiting Solutions: Driving Careers, Transforming Healthcare. Requirements Qualifications: • Education: Master's or Doctoral degree in Nursing from an accredited Nursing program., • Licensure:, • Active and unrestricted NP license. Active DEA registration., • Active Medicaid provider status., • Experience: Minimum of 2 years of experience as a Psychiatric Mental Health Nurse Practitioner (PMHNP)., • Language: Spanish preferred., • Competitive Compensation: Earn a competitive annual salary of $135,000 - $145,000/yr., • Comprehensive Benefits:, • Medical, Dental, and Vision insurance, • Flexible Spending Account, • Paid Time Off, • Retirement Savings, • Commuter Benefits program, • Visa Sponsorship opportunities, • Malpractice insurance coverage, • Loan repayment, • Flexible schedules, • Stable Employment, • Exclusive 20% Discount Tuition Reduction with local College

Job DescriptionHealthPlus Staffing is assisting a well established organization with their search for a Nurse Practitioner to join their team in South Bronx, NY. With over 35 clinics and over half a million patients across the 5 boroughs and Long Island, the growth potential is exponential. Job Description: • Location: South Bronx, NY, • Position: Nurse Practitioner, • Specialty: Primary Care, • Structure: Outpatient (No call), • Start: 30-60 days Days, • Schedule: Full-Time (40 hours), • Duties: Consultations, Follow up, Physical exams, • EMR: Epic, • Support: Full Office Staff and APP, • Compensation: 120-145K, • Benefits: Full Package Qualifications:, • Unrestricted NY license, • BC/BE as a Nurse Practitioner, • Active DEA registration, • Must possess active Medicare/Medicaid Enrollment or be eligible to enrollIf interested in this position please apply immediately and someone will be in contact within 24 hours of submission.

Job DescriptionHealthPlus Staffing is assisting a well established organization with their search for a Nurse Practitioner to join their team in East New York. With over 35 clinics and over half a million patients across the 5 boroughs and Long Island, the growth potential is exponential. Job Description: • Location: East New York, • Position: Nurse Practitioner, • Specialty: Primary Care, • Structure: Outpatient (No call), • Start: 30-60 days Days, • Schedule: Full-Time (40 hours), • Duties: Consultations, Follow up, Physical exams, • EMR: Epic, • Support: Full Office Staff and APP, • Compensation: 120-145K, • Benefits: Full Package Qualifications:, • Unrestricted NY license, • BC/BE as a Nurse Practitioner, • Active DEA registration, • Must possess active Medicare/Medicaid Enrollment or be eligible to enrollIf interested in this position please apply immediately and someone will be in contact within 24 hours of submission.

Job DescriptionHealthPlus Staffing is assisting a well established organization with their search for a Nurse Practitioner to join their team in Brooklyn, NY. With over 35 clinics and over half a million patients across the 5 boroughs and Long Island, the growth potential is exponential. Job Description: • Location: Brooklyn, NY (Crown Heights), • Position: Nurse Practitioner, • Specialty: Primary Care, • Structure: Outpatient (No call), • Start: 30-60 days Days, • Schedule: Full-Time (40 hours), • Duties: Consultations, Follow up, Physical exams, • EMR: Epic, • Support: Full Office Staff and APP, • Compensation: 120-145K, • Benefits: Full Package Qualifications:, • Unrestricted NY license, • BC/BE as a Nurse Practitioner, • Active DEA registration, • Must possess active Medicare/Medicaid Enrollment or be eligible to enrollIf interested in this position please apply immediately and someone will be in contact within 24 hours of submission.

Job Description Psychiatric Mental Health Nurse Practitioner (PMHNP) / Hybrid - Bronx, NY (#3336A) • Location: Bronx, New York, • Employment Type: Full-time, • Salary: $135,000 - $150,000/yr About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Position Overview: We are seeking a dedicated Psychiatric Mental Health Nurse Practitioner (PMHNP) for a hybrid role with a multi-specialty practice in the Bronx. Why Join Us? • Work Schedule: Full-time., • Hybrid Work Model: Enjoy the flexibility of a hybrid schedule, requiring on-site presence once per week., • Professional Growth: Gain valuable experience in a collaborative, innovative, and supportive environment., • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes. Key Responsibilities: • Conduct comprehensive psychiatric evaluations and assessments, including diagnosis of mental health and substance use disorders., • Develop, implement, and evaluate individualized treatment plans in collaboration with patients and their families., • Provide psychopharmacological evaluation and medication management, including prescription of psychotropic medications., • Utilize therapeutic communication to provide psychotherapy and counseling to individuals across the lifespan., • Order and interpret diagnostic tests and laboratory results as needed to support diagnosis and treatment., • Maintain accurate, timely, and confidential electronic medical records in compliance with state and federal regulations., • Collaborate effectively with physicians, therapists, social workers, and other members of the multidisciplinary care team., • Provide patient and family education regarding diagnosis, treatment options, and mental health wellness., • Participate in case conferences, clinical supervision, and continuing education to ensure the highest standard of care. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives. Requirements Qualifications: • Education: Master's or Doctoral degree in Nursing from an accredited Nursing program., • Licensure:, • Active and unrestricted NP license. Active DEA registration., • Active Medicaid & Medicare provider status., • Experience: Minimum of 2 years of experience as a Psychiatric Mental Health Nurse Practitioner (PMHNP)., • Language: Must be Bilingual in Spanish., • Soft Skills: Strong clinical and interpersonal skills., • Competitive Compensation: Earn a competitive annual salary of $135,000 - $150,000/yr., • Comprehensive Benefits:, • Medical, Dental, and Vision insurance, • Flexible Spending Account, • Paid Time Off, • Retirement Savings, • Commuter Benefits program, • Visa Sponsorship opportunities, • Malpractice insurance coverage, • Loan repayment, • Flexible schedules, • Stable Employment, • Exclusive 20% Discount Tuition Reduction with local College

Job DescriptionAthenaPsych is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges. We specialize in individual and group psychotherapy for clients with a focus on trauma-informed care. We are dedicated to improving the quality and accessibility of mental health care for all, especially individuals from underserved communities. Here at AthenaPsych, we pride ourselves on hiring a diverse group of mental health clinicians and staff who are passionate and dedicated to improving our client’s overall emotional well-being. We provide both in-person and telehealth services for our clients and offer a competitive fee-for-service compensation plan and amazing benefits to our staff. Are You a Good Fit For Us?We are currently seeking an experienced, professional, and compassionate Psychiatric Nurse Practitioner to join our growing organization. Flexible hours are provided with the need of some evening hours, in-person and telehealth sessions. This position will work in collaboration with our Psychiatrist on staff. Our mental health clinic is located at 33 W 60th St 6th floor New York, NY.Responsibilities • Conduct psychiatric evaluations for all Athena clients (children and adults), • Conduct ongoing medication management when needed, • Complete all required documentation by a given deadline and in compliance with program and state regulations, • Ensures all clinical notes and client information are updated and accurate within the current EHR system, • Provide conflict resolution and crisis intervention when needed, • Work in collaboration with administrative staff to ensure client needs are successfully met, • Ability to commute between sites when neededQualifications, • Master's Degree in Nursing from an accredited school, • Bilingual in English and Spanish A MUST, • Must be certified with the Drug Enforcement Administration in order to prescribe medication to clients, • Must be licensed in New York State, • Experience working with Medicaid/Medicare Clients is a plus

Job DescriptionCompany Description About NYPCC New York Psychotherapy and Counseling Center (NYPCC) is New York State’s largest community mental health clinic, serving more than 15,000 clients each month through accessible in-person and telehealth services. With over 50 years of experience, we remain deeply committed to clinical excellence and meaningful care for the communities we serve. In 2025, NYPCC was recognized by City & State as both a Top Place to Work and a Top Mental Health Care Provider in New York, and we are proud to hold Mental Health America’s Platinum Bell Seal. These honors reflect our mission-driven culture and our strong emphasis on employee well-being, professional growth, and lasting impact. Why Work For NYPCC: • Excellent Rates, • Flexible Schedule, • Amazing Workplace Culture, • Opportunity to Give Back to the Community, • Job Stability and Growth Opportunities, • Full Benefits Available for Full-Time Positions We are currently seeking warm and empathetic Psychiatric Nurse Practitioners. Full-Time hybrid positions are available with flexible scheduling. The position will be based out of the following location: 102 Pilling St. Brooklyn. Job Description As a member of a multidisciplinary treatment team, and under the supervision of a psychiatrist (if required), the Psychiatric Nurse Practitioner will provide advanced clinical psychiatric nursing care, including: • Performing psychiatric evaluations and ongoing medication management of clients, • Prescribing or recommending medication or other forms of treatment or related therapeutic procedures, • Ordering, interpreting, and evaluating diagnostic tests to identify and assess clients' clinical problems and health care needs, • Ordering laboratory tests and other diagnostic procedures, • Referring clients to specialized health resources for treatment, • Performing crisis intervention, • Communicating with healthcare professionals, families, and staff members to ensure ongoing quality delivery of health services, • May be asked to cover other sites if necessaryQualifications, • Master’s degree in Nursing from an accredited nurse practitioner program is required, • Must be currently licensed in New York State as a psychiatric nurse practitioner, • Must be currently certified with the DEA to prescribe medication., • Bilingual in English and Spanish is not required but preferred, • Excellent interpersonal communication skills and ability to work collaboratively with other disciplines, including clinical and clerical staff, • Excellent assessment, diagnostic and psychopharmacological treatment skills, • Strong clinical skills working with individuals with mental illness, • Dedication to team-based care, • Proven ability to work independently and as part of a team, to assist children and adults of diverse backgrounds, ages, ethnicities and sexual preferences., • Must be registered as a NY State Medicaid provider. Must have a DEA# and an individual NPI #. Additional Information Compensation commensurate with experience and qualifications. In addition, our licensed professionals have free access to our online Continuing Education Courses. Perkins and other loan forgiveness may also be available, in addition to our Student Loan Pay Down incentive. New York Psychotherapy and Counseling Center is a fast-paced, energetic, dynamic environment that employs people with a passion for our mission. We offer a competitive salary and flexible hours. Annually: $125-150k Compensation commensurate with experience and qualifications. NYPCC is an Equal Opportunity Employer

Job Description Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Bronx, NY. This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms, all while enjoying a schedule designed with your preferences in mind. Whether it be for supplemental income or the desire for community connection, this position invites you to become an integral part of the thriving HRA landscape, fostering connections that go beyond the clinic. Benefits include: • Competitive compensation: $90 or $115 per completed assessment, • Flexible schedule, • Comprehensive home assessment training, • Dedicated patient scheduling assistance Qualified Nurse Practitioners and Physician Assistants interested in this position will have the opportunity to interact with members in a more intimate setting. Unlike a typical clinic visit, this role allows NPs and PAs to connect with patients on a more personal and effective level. Nurse Practitioners and Physician Assistants performing HRAs are not required to treat or prescribe in the home. Nurse Practitioner/Physician Assistant Responsibilities • Travel to and from patients’ homes., • Perform comprehensive, non-invasive physical assessments., • Review medical history and ensure accurate and timely documentation., • Conduct medical reconciliation to ensure patient safety and compliance., • Master’s Degree OR commensurate experience and satisfactory completion of NP/PA license, • Active State NP/PA license, • Active National board certification, • Current BLS certification About Hueman At Hueman, we're dedicated to guiding you toward fulfilling career opportunities. We believe that happiness should be a fundamental part of every role in risk assessment. Our opportunities provide flexibility, extra income, and integration into your local healthcare network. If this resonates with your idea of career satisfaction, allow us to assist you in discovering your next healthcare position! #Purple

Job Description JOB SUMMARY: As a member of a multidisciplinary treatment team, the Psychiatric Nurse Practitioner provides advanced clinical psychiatric nursing care to referred clients. Performs psychiatric evaluations and psychiatric medication management for clients in ongoing treatment. Ensures accuracy of diagnosis and appropriate pharmacologic interventions and supports appropriate multidisciplinary interventions. Provides clinical leadership within the team to recommend program placement and coordinate treatment planning. ESSENTIAL JOB FUNCTIONS: List all essential job duties. (To perform this job successfully, an individual must be able to perform each essential duty listed satisfactorily with or without a reasonable accommodation. Reasonable accommodations may be made to enable qualified individuals with a disability to perform the essential duties unless this causes undue hardship to the agency.) • Performs comprehensive, diagnostic psychiatric evaluations and provides ongoing medication management and treatment for clients., • Obtains medical history and performs physical examinations and preventive health measures within prescribed guidelines., • Observes client progress, records findings and formulates plan and prognosis based on client’s condition. Discusses case with supervising psychiatrist, other treatment team members and other health professionals to prepare comprehensive care plan., • Submits health care plan and goals of individual clients for periodic review and evaluation with the psychiatrist., • Prescribes or recommends medication or other forms of treatment such as physical therapy, diet, inhalation therapy, or related therapeutic procedures. Prescribes or recommends continuation or discontinuation of medications and treatment., • Orders, interprets, and evaluates diagnostic tests to identify and assess clients' clinical problems and health care needs. Orders laboratory tests, x-rays, and other diagnostic procedures., • May refer clients to psychiatrist for consultation or specialized health resources for treatment., • Cultivates clinical staff quality of care through consultation with and education of interdisciplinary personnel, clients, and their significant others., • Performs crisis intervention using verbal and nonverbal techniques., • May have on-call responsibilities and provide periodic clinical coverage for colleagues., • Immediately reports serious incidents, serious incident allegations, incidents, or sensitive situations to supervisors., • Attends regularly scheduled clinical meetings and supervision., • Attends professional development activities and training., • May precept nursing students and nurse practitioner students., • May be assigned as a participant or facilitator of agency committee(s), • Ability to effectively respond to and manage behavioral health emergencies, • Ability to perform and interact as part of a multi-disciplinary team. Ability to prepare documentation in a timely manner, • Ability to effectively communicate both orally and in writing, including communication by electronic means, • Knowledge of emergency psychiatric treatments and interventions, • Knowledge of teaching and consultation techniques, • Knowledge of the Agency's policies and procedures, • Knowledge of cultural, ethnic, and linguistic needs of clients in a culturally competent manner Master’s or Doctorate degree in nursing from an accredited nurse practitioner program and currently licensed in New York State as a Psychiatric Mental Health Nurse Practitioner (PMHNP). Current DEA certification. ANCC certification is an asset. Two years’ experience with individuals suffering from co-occurring severe psychiatric conditions and substance use disorders. Must be eligible for full and unconditional participation in the Medicaid and Medicare programs. May be required to possess a valid NYS driving license and a clear driving record. Continued employment is based on the ability to maintain professional licensure and accreditation, and participation in the Medicaid and Medicare programs.

Job Description Stable and growing organization is looking to hire a Nurse Practitioner or Physician Assistant to work in the Brooklyn, NY area! Join a group of like-minded, energetic, and mission-driven medical providers working together to dramatically improve the lives and health of vulnerable geriatric patients — while maintaining an excellent work/life balance. About the Company: Founded in 2007, this established and rapidly expanding healthcare organization specializes in caring for geriatric patients residing in assisted living facilities throughout New York. • Serving patients across 50+ assisted living facilities, • Experiencing significant growth with strong provider retention and high satisfaction rates, • Focused mission: Keep patients healthy and out of the hospital Benefits and Features: • $70/hour — approximately $145,000 annually, • 20 Days PTO, • $10,000/year Health Insurance Reimbursement The Role: Providers conduct video visits from a clean, well-supported clinic environment in Brooklyn. On-site Medical Assistants and med techs at the assisted living facilities assist with vitals and exam preparation, allowing you to focus on clinical decision-making — without the noise and unpredictability of traditional facility rounding. • Full-time, Monday–Friday, No nights, no weekends, • Work out of the Brooklyn clinic conducting video visits with patients in assisted living facilities, • Medical Assistants on-site perform vitals and assist with coordination, • Goal is proactive management of geriatric patients to prevent hospitalizations, • This is an ideal role for a provider who enjoys geriatric medicine and wants high-impact patient care in a structured, efficient setting Background Desired: • Licensed Nurse Practitioner or Physician Assistant in New York, • Active DEA License, • Must already be credentialed with Medicare and NY State Medicaid Why This Role? • Make a measurable impact by reducing hospital admissions, • Work in a clean, controlled clinic environment, • Be part of a supportive, expanding team, • Enjoy consistent hours and predictable scheduling, • Join an organization that values provider comfort and retention FOR MORE INFORMATION CONTACT: Katie Patterson 843-574-8234

Job Description Psychiatric Mental Health Nurse Practitioner (PMHNP) / Hybrid - Bronx, NY (#3336A) Location: Bronx, New York Employment Type: Full-time Salary: $135,000 - $150,000/yr Position Overview: We are seeking a dedicated Psychiatric Mental Health Nurse Practitioner (PMHNP) for a hybrid role with a multi-specialty practice in the Bronx. Why Join Us? • Competitive Compensation: Earn a competitive annual salary of $135,000 - $150,000/yr., • Comprehensive Benefits:, • Medical, Dental, and Vision insurance, • Flexible Spending Account, • Paid Time Off, • Retirement Savings, • Commuter Benefits program, • Visa Sponsorship opportunities, • Malpractice insurance coverage, • Loan repayment, • Flexible schedules, • Stable Employment, • Exclusive 20% Discount Tuition Reduction with local College, • Work Schedule: Full-time., • Hybrid Work Model: Enjoy the flexibility of a hybrid schedule, requiring on-site presence once per week., • Professional Growth: Gain valuable experience in a collaborative, innovative, and supportive environment., • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes. Qualifications: • Education: Master's or Doctoral degree in Nursing from an accredited Nursing program., • Licensure:, • Active and unrestricted NP license. Active DEA registration., • Active Medicaid & Medicare provider status., • Experience: Minimum of 2 years of experience as a Psychiatric Mental Health Nurse Practitioner (PMHNP)., • Language: Must be Bilingual in Spanish., • Soft Skills: Strong clinical and interpersonal skills., • Residence: Must be residing in the tri-state area. Key Responsibilities: • Conduct comprehensive psychiatric evaluations and assessments, including diagnosis of mental health and substance use disorders., • Develop, implement, and evaluate individualized treatment plans in collaboration with patients and their families., • Provide psychopharmacological evaluation and medication management, including prescription of psychotropic medications., • Utilize therapeutic communication to provide psychotherapy and counseling to individuals across the lifespan., • Order and interpret diagnostic tests and laboratory results as needed to support diagnosis and treatment., • Maintain accurate, timely, and confidential electronic medical records in compliance with state and federal regulations., • Collaborate effectively with physicians, therapists, social workers, and other members of the multidisciplinary care team., • Provide patient and family education regarding diagnosis, treatment options, and mental health wellness., • Participate in case conferences, clinical supervision, and continuing education to ensure the highest standard of care.

Job Description Psychiatric Mental Health Nurse Practitioner (PMHNP) / Hybrid - Bronx, NY (#1669) Location: Bronx, New York Employment Type: Full-time Salary: $135,000 - $150,000/yr About Impact Recruiting Solutions: Impact Recruiting Solutions is a dedicated recruitment partner connecting healthcare professionals with rewarding opportunities. We collaborate with hospitals, clinics, and multi-specialty facilities to match skilled individuals with roles that align with their expertise and career aspirations. Position Overview: We are seeking a dedicated Psychiatric Mental Health Nurse Practitioner (PMHNP) for a hybrid role with a multi-specialty practice in the Bronx. Why Join Us? • Competitive Compensation: Earn a competitive annual salary of $135,000 - $150,000/yr., • Comprehensive Benefits:, • Medical, Dental, and Vision insurance, • Flexible Spending Account, • Paid Time Off, • Retirement Savings, • Commuter Benefits program, • Visa Sponsorship opportunities, • Malpractice insurance coverage, • Loan repayment, • Flexible schedules, • Stable Employment, • Exclusive 20% Discount Tuition Reduction with local College, • Work Schedule: Full-time, • Hybrid Work Model: Enjoy the flexibility of a hybrid schedule, requiring on-site presence once per week., • Professional Growth: Gain valuable experience in a collaborative, innovative, and supportive environment., • Education: Master's or Doctoral degree in Nursing from an accredited Nursing program., • Licensure:, • Active and unrestricted NP license. Active DEA registration., • Active Medicaid provider status., • Experience: Minimum of 2 years of experience as a Psychiatric Mental Health Nurse Practitioner (PMHNP)., • Language: Spanish required., • Conduct comprehensive psychiatric evaluations and assessments, including diagnosis of mental health and substance use disorders., • Develop, implement, and evaluate individualized treatment plans in collaboration with patients and their families., • Provide psychopharmacological evaluation and medication management, including prescription of psychotropic medications., • Utilize therapeutic communication to provide psychotherapy and counseling to individuals across the lifespan., • Order and interpret diagnostic tests and laboratory results as needed to support diagnosis and treatment., • Maintain accurate, timely, and confidential electronic medical records in compliance with state and federal regulations., • Collaborate effectively with physicians, therapists, social workers, and other members of the multidisciplinary care team., • Provide patient and family education regarding diagnosis, treatment options, and mental health wellness. Impact Recruiting Solutions: Driving Careers, Transforming Healthcare.

Job Description Child Psychiatry PMHNP / Hybrid - Bronx, NY (#1673) Location: Bronx, New York Employment Type: Full-time or Part-time, Hybrid (on-site once weekly) Salary: $140,000 - $150,000 annually About Impact Recruiting Solutions: Impact Recruiting Solutions is a dedicated recruitment partner connecting healthcare professionals with rewarding opportunities. We collaborate with hospitals, clinics, and multi-specialty facilities to match skilled individuals with roles that align with their expertise and career aspirations. Position Overview We are seeking a Child Psychiatric Mental Health Nurse Practitioner (PMHNP) to provide specialized mental health services to patients aged 6 and above in a multi-specialty practice in the Bronx, NY. This hybrid position offers the flexibility of remote work with only one on-site day per week. Bilingual candidates are required. Why Join Us? • Competitive Compensation: $140,000 - $150,000 per year, • Comprehensive Benefits:, • Medical, Dental, and Vision Insurance, • Flexible Spending Account, • Paid Time Off & Retirement Savings, • Commuter Benefits Program, • Malpractice Insurance Coverage, • Loan Repayment Assistance, • Visa Sponsorship Opportunities, • Exclusive 20% Tuition Discount at Local College, • Work Schedule: Full-time or Part-time, Hybrid (on-site once weekly), • Professional Growth: Collaborative multi-specialty environment, • Education: Master of Science in Nursing or higher from an accredited PMHNP program, • Licensure: Active New York State PMHNP License, • Experience: Minimum 2 years of experience with children aged 6 and above, • Requirements: Must have an active Medicaid; Bilingual (mandatory), • Technical Skills: Child psychiatric assessment, medication management, therapy modalities, • Provide psychological assessment and therapy to children aged 6 or above, • Conduct diagnostic evaluations and develop treatment plans, • Maintain active Medicaid provider status, • Collaborate with team members, • Provide culturally competent care to diverse populations Impact Recruiting Solutions: Driving Careers, Transforming Healthcare.

Job Description Child Psychiatry PMHNP / Hybrid - Bronx, NY (#1673) Location: Bronx, New York Employment Type: Full-time or Part-time, Hybrid (on-site once weekly) Salary: $140,000 - $150,000 annually About Impact Recruiting Solutions: Impact Recruiting Solutions is a dedicated recruitment partner connecting healthcare professionals with rewarding opportunities. We collaborate with hospitals, clinics, and multi-specialty facilities to match skilled individuals with roles that align with their expertise and career aspirations. Position Overview We are seeking a Child Psychiatric Mental Health Nurse Practitioner (PMHNP) to provide specialized mental health services to patients aged 6 and above in a multi-specialty practice in the Bronx, NY. This hybrid position offers the flexibility of remote work with only one on-site day per week. Bilingual candidates are required. Why Join Us? • Work Schedule: Full-time or Part-time, Hybrid (on-site once weekly), • Professional Growth: Collaborative multi-specialty environment, • Impactful Work: Make a meaningful difference in children's mental health Key Responsibilities • Provide psychological assessment and therapy to children aged 6 or above, • Conduct diagnostic evaluations and develop treatment plans, • Maintain active Medicaid provider status, • Collaborate with team members, • Provide culturally competent care to diverse populations Qualifications • Education: Master of Science in Nursing or higher from an accredited PMHNP program, • Licensure: Active New York State PMHNP License, • Experience: Minimum 2 years of experience with children aged 6 and above, • Requirements: Must have an active Medicaid; Bilingual (mandatory), • Technical Skills: Child psychiatric assessment, medication management, therapy modalities, • Competitive Compensation: $140,000 - $150,000 per year, • Comprehensive Benefits:, • Medical, Dental, and Vision Insurance, • Flexible Spending Account, • Paid Time Off & Retirement Savings, • Commuter Benefits Program, • Malpractice Insurance Coverage, • Loan Repayment Assistance, • Visa Sponsorship Opportunities, • Exclusive 20% Tuition Discount at Local College

Description of Duties: • Present to, follow up and sell Individual Medicaid, Essential Plan, QHP and CHP products on a direct sales basis. Assist and enroll individuals by completing the appropriate application forms, obtain required documentation necessary for enrollment, and meeting necessary enrollment targets., • Conduct home visits and other appointments as needed to complete the application and obtain all required documentation., • Develop and maintain appropriate understanding of the health care products related to sales responsibility. Successfully complete periodic certification and testing to maintain knowledge level established by regulations., • Maintain appointments, develop community marketing sites, establish relationship with community based organizations, Participate in health related activities / special events including evening and weekend activity, create self-generated leads, and provide services to walk-ins. Obtains feedback from referral sources and prospective enrollees., • Stimulates word-of-mouth referrals from participants, prospects and their families., • Utilize automated tools to perform individual enrollment duties., • Refer all existing members up for recertification to Retention Specialist when applicable., • Perform recertification activities when necessary., • Function as a liaison between all EmblemHealth departments to help identify and capture prospect's problems or concerns. Work with Neighborhood care team to maintain and improve EmblemHealth's image as a High Quality and Affordable health plan in the community., • Assist members with selecting a Primary Care Physician (PCP) using the provider directory., • Present EmblemHealth insurance products and benefit plans to community groups, small businesses and other prospective subscribers., • Develop and execute sales plan which focuses on growth of the individual products in the assigned neighborhood. Maintain and grow book of enrollments. Enrollment activities include on-site coverage at hospitals, provider offices, City agencies, community business partners and Community Based Organizations (CBO's). All activity entered into Salesforce tool., • Performs other duties as assigned or required, • Regular attendance is an essential function of the job. Qualifications:, • High School Diploma or equivalent required, • 4 years of relevant sales experience preferred, • Driver's License and automobile with appropriate coverage is required for territories - Long Island, etc., • Travel in the New York metropolitan area required, • Must be able to work nights and weekends as required, • Excellent interpersonal and presentation skills and the ability to work independently., • Excellent organizational and communication skills, both verbal and written, • Ability to develop strong relationships and influences in the community, • Ability to input and update data in database system, • Works independently and produces Self-Generated leads, • Ability to multi-task, • Successful completion of annual product training and testing to maintain regulatory certification Additional Information, • Requisition ID: 1000002169_10, • Hiring Range: $50,000 - $60,000

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Work with Network Planning and Operations to maintain provider information and provide clerical support. Add providers to the system as needed, coordinate application submissions, update and change provider demographic information, communicate with provider offices to obtain information and perform general office duties.High school degree or equivalent. Minimum of 2 years experience in health care or managed care environment. Must be computer literate, able to perform word processing and work with Excel. Knowledge of medical billing a plus. Must possess strong communication skills and a customer service orientation. Able to type a minimum of 45 wpm.

AdvantageCare Physicians (ACPNY) is a primary and specialty care practice serving half a million patients across the New York metropolitan area. With more than 30 medical offices across New York City's five boroughs and Long Island, ACPNY is continually expanding our practice and enhancing our services for communities throughout New York. As we grow, our employees grow with us. Summary of Position We are seeking an Endocrinology trained physician to join our multispecialty group in pursuit of high quality patient care to provide full scope Endocrinology services. The Ideal Candidate • One to three years of endocrinology clinical experience in an outpatient setting., • Patient-centered approach toward a positive patient experience., • Excellent communication skills., • Interest in Population Health Management. Principal Accountabilities • Provide comprehensive cost-effective diabetes care with available support of CDE/RD services., • Prescribe medications and formulate ongoing treatment and disease management plans., • Communicate effectively with the clinical team to ensure total delivery of quality care., • Participate in medical staff educational programs and meetings. Qualifications Education, Training, Licenses, Certifications • Doctor of Medicine (MD), Doctor of Osteopathy (DO) or foreign equivalent. Relevant Work Experience, Knowledge, Skills, and Abilities • Seeking both experienced and newly trained providers, • Board Eligible/Board Certified in both Internal Medicine and Endocrinology, • Must possess current, unrestricted New York State license., • Must possess Drug Enforcement Agency (DEA) registration or be eligible for registration., • Must possess Medicare/Medicaid Enrollment or be eligible to enroll., • BLS or ACLS certification required., • Must possess strong communication skills both oral and written., • Comfortable with Electronic Medical Record (EMR) system and Microsoft Office. Additional Information, • Requisition ID: 1000002096, • Hiring Range: $320,000-360,000

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Insure high quality, cost-effective care and services for Elderplan members through support of professional Care Management and/or Clinical Service activities. The position supports all aspects of care coordination for our Medicare, Medicaid, and/or dual product members in compliance with all departmental and regulatory requirements. • Processes all newly enrolled cases according to established EP/HF Coordinated Care team workflows and maintains integrity of members' files, • Receives and processes requests and inquiries through interdepartmental communication system regarding covered/ non covered services/supplies, • Receives and processes initial requests and inquiries regarding pre-authorization of services/supplies., • Coordinates and provides service authorizations to vendors, • Accurate and timely data entry support as defined by departmental workflows, • Participates in scheduled team meetings, • High School Diploma or equivalent; college degree preferred., • One year prior managed care experience required., • Prior experience in a health care setting preferred., • Familiarity with utilization management/case management.

AdvantageCare Physicians (ACPNY) is a primary and specialty care practice serving half a million patients across the New York metropolitan area. With more than 30 medical offices across New York City's five boroughs and Long Island, ACPNY is continually expanding our practice and enhancing our services for communities throughout New York. As we grow, our employees grow with us. Summary of Position We are seeking an experienced Internal or Family Medicine trained physician to join us in pursuit of high-quality patient care to provide a full scope of primary care services including but not limited to diagnosis, treatment, coordination of care, preventive care and health maintenance. The Ideal Candidate: • Must Have a minimum of two to three years of primary clinical experience in an outpatient setting., • Ability to diagnose and treat a wide variety of chronic conditions and improve patient outcomes., • Demonstrate competency in diagnosis and treatment to assure high standards of patient care and safety are maintained., • Patient-centered approach toward a positive patient experience., • Excellent communication skills., • Interest in Population Health Management. Principal Accountabilities • Review patient's history and perform physical examinations. Evaluate, diagnose and provide appropriate treatment and patient care. Refer patient to specialist as needed., • Prescribe medications and formulate ongoing treatment and disease management plans., • Provide relationship-centered care, considering the patient's psychosocial and physical needs., • Collect and record patient information, such as medical histories, reports and examination, • results. Maintain complete and accurate medical records., • Communicate effectively with the clinical team to insure total delivery of quality care., • Participate in medical staff educational programs and meetings. Qualifications Education, Training, Licenses, Certifications • Doctor of Medicine (MD), Doctor of Osteopathy (DO) or foreign equivalent Relevant Work Experience, Knowledge, Skills, and Abilities • Relevant Work Experience, Knowledge, Skills, and Abilities, • Seeking experienced outpatient providers, • Board Eligible/Board Certified in Internal Medicine or Family Medicine, • Must possess current, unrestricted New York State license., • Must possess active Drug Enforcement Agency (DEA) registration or be eligible for registration, • Must possess active Medicare/Medicaid Enrollment or be eligible to enroll, • BLS or ACLS required., • Requisition ID: 1000003029, • Hiring Range: $250,000-$280,000

Summary of Job Partner with G&A team to review pharmacy appeals, pharmacy benefit appeals, and related medical appeals, including process refinement, with responsibility for Level 1 and Level 2 appeals. Coordinate analysis of appeals determination trends and quality measures with pharmacy benefits management (PBM) vendor and company-wide quality and compliance teams. Partner with PBM vendor and with Pharmacy Performance team to support IRO preparation and responses. Responsible for managing performance of staff and activities related to Pharmacy quality and compliance including but not limited to monitoring and trending of key performance indicators (KPIs) and compliance reports relative to safety reporting processes and regulatory authority submissions. Provide active oversight and ongoing direction for the utilization management Pharmacy team and quality assurance process including case review, review with staff and monthly scoring. Direct the management reporting on productivity, clinical quality, compliance with state and federal pharmacy requirements and timelines. Lead, develop and enforce standards of quality, quality assurance, and monitoring for the utilization management function and staff. Work with practitioners and formulary and vendor to update clinical decision trees, which will enhance the efficiency of the team. Responsibilities • Manage the day-to-day functions of the Clinical Pharmacy quality assurance process for appeals., • Direct and ensure Appeals queue management for timeliness and workforce modeling., • Work collaboratively with health plan market leads to lead Plan-sponsored initiatives designed to assist and empower members in closing gaps., • Analyze audit and inspection findings and suggest remediation as well as maintain overview of CAPA responses and resulting measures, • Track trends in quality reviews, drugs, costs and review with senior leadership., • Exercise considerable latitude in determining objectives and approaches to strategy for the utilization management program's success across the enterprise., • Review high dollar reports (medical drugs exceeding 50k threshold for appropriateness and billable units)., • Develop, implement, and maintain UM appeals reporting, including appeals dashboard, practitioner scorecard, timeliness, denial language, and federal/state regulatory compliance., • Responsible for identifying training needs for staff (in-service) and developing and overseeing training to ensure awareness of and compliance with organizational objectives and applicable laws and regulatory requirements., • Design, review and use plan tools, reports and system results to conduct weekly, monthly, and quarterly reviews with department staff. Maintain staff-specific scorecards to be shared monthly., • Review requests for authorization for Medicare, NYS Medicaid, Commercial, and Exchange lines of business., • Responsible for development and maintenance of Utilization Management Trees to improve efficiency of the staff., • Participate in the Pharmacy & Therapeutic Committee to include Step-Protocol Review, Non-Formulary Review, Subcommittee Management (Meetings), Drug Reviews, and Updates., • Support HCCI initiatives as necessary, • Contribute to the design and development of policies, procedures, and operating guidelines., • Doctor of Pharmacy degree or master's in pharmacy from an accredited school of pharmacy, • Registered Pharmacist: New York State pharmacy license (Required), • Board certification - (Pharmacotherapy, Ambulatory Care, Geriatrics, Internal Medicine, Pediatrics (Preferred), • 10 - 12+ years of relevant, professional experience (Required), • 2+ years of staff and/or process management experience (Preferred), • 5+ years of pharmacist experience (Required), • Utilization Management experience (Required), • Residency or 5 years' clinical experience (Preferred), • Knowledge of pharmaceuticals and disease states to provide advice and consultation to providers and members and recommend changes to the formulary (Required), • Possess research and analytical skills sufficient to provide problem resolution and consultation to providers (Required) Excellent verbal and written communication skills sufficient to prepare own correspondence and interact with members and providers in provision of advice and guidelines (Required) Additional Information • Requisition ID: 1000002998, • Hiring Range: $92,880-$178,200

Risk Adjustment Program Manager New York, NY (Hybrid) | $125,000 to $145,000 A leading not-for-profit health plan is seeking a Risk Adjustment Program Manager to support risk adjustment initiatives across Medicare, Medicaid, and Exchange populations. Hybrid: 2 days a week in the NYC office and 3 days a week remote. This could possibly become 100% remote in the future. Responsibilities: • Ensure accuracy of encounter submissions and resolve data discrepancies, • Identify and close risk score gaps through data analysis and provider collaboration, • Analyze program performance and refine risk adjustment strategies, • Oversee reporting, analytics, and vendor performance, • Ensure compliance with CMS and state regulations, • Lead projects, including RFPs and vendor implementations, • Supervise and mentor analysts Qualifications:, • Bachelor’s degree required (Master’s preferred), • 6+ years healthcare experience, including 3+ years in Risk Adjustment, • Knowledge of risk models (CMS-HCC, HHS-HCC, 3M CRG), • Strong analytical skills (SQL or similar preferred), • Experience in health plan, provider, or vendor environment This is a high-visibility, strategic role offering growth and the opportunity to make a meaningful impact within a mission-driven organization. #AC1 #ACP

Job Description Posted on 3/25/2026 Title: Home Remediation Services Assistant Reports To: Home Remediation Supervisor – Enhanced Services Role Description The Home Remediation Assistant provides direct support to the Home Remediation Supervisor in coordinating and documenting services that ensure Medicaid members’ dwellings remain safe, healthy, and accessible. This role focuses on intake, scheduling, quality assurance tracking, billing support, and clerical functions that keep remediation projects running smoothly. The ideal candidate will be highly organized, detail-oriented, and comfortable interacting with clients, vendors, and program staff. Key Responsibilities Client Intake & Scheduling • Conduct intake calls with Medicaid members referred for home remediation services., • Collect and record client information, service needs, and consent forms., • Schedule dwelling assessments, service visits, and post-remediation inspections., • Maintain the Supervisor’s calendar and coordinate vendor appointments., • Dwelling Assessment Support, • Assist in preparing dwelling assessment packets and checklists for Supervisors., • Input assessment findings into the system and ensure accuracy of supporting documentation., • Track progress of remediation projects from initial referral to closure., • Quality Assurance Reporting, • Support quality assurance by logging results from post-project inspections., • Support the maintenance of project files, including Statements of Work (SOWs),, • medical necessity documentation, and compliance forms., • Prepare draft reports and dashboards for Supervisor review., • Invoice Billing Support, • Collect vendor invoices, verify accuracy against service logs, and prepare for, • Supervisor approval., • Assist with billing entries for Medicaid reimbursement and track payment status., • Maintain filing systems (digital and physical) for client and vendor records., • Respond to inquiries from members, Social Care Navigators, and contractors., • Associate degree or equivalent work experience in office administration, health services, or construction-related fields., • 2+ years of administrative or program support experience (healthcare, housing,or social services preferred)., • Strong organizational and multitasking skills with attention to detail., • Proficiency with Microsoft Office, databases, and scheduling software., • Strong written and verbal communication skills., • Ability to work collaboratively with diverse populations, contractors, and staff., • Commitment to client confidentiality and compliance with Medicaid documentation standards.Company DescriptionCABS Health Network, (CABS) is a well-established Licensed Home Care Agency located in Brooklyn, New York, an innovative home healthcare agency with a 40-year history in the home healthcare industry. CABS is proud to offer a wide range of comprehensive services to meet the needs of seniors, adults, and other patients. The company’s team of professional caregivers specializes in providing personalized medical care, rehabilitative therapy, and companion assistance.CABS Health Network, (CABS) is a well-established Licensed Home Care Agency located in Brooklyn, New York, an innovative home healthcare agency with a 40-year history in the home healthcare industry. CABS is proud to offer a wide range of comprehensive services to meet the needs of seniors, adults, and other patients. The company’s team of professional caregivers specializes in providing personalized medical care, rehabilitative therapy, and companion assistance.

ElderServe Health is a mission-driven, nonprofit managed care organization serving the New York metropolitan area. ElderServe provides long-term services and supports to more than 20,000 older adults and adults with disabilities across New York City, as well as Westchester, Nassau, and Suffolk Counties. ElderServe primarily serves a frail and elderly membership who is predominantly dual-eligible and enrolled in Medicaid managed long-term care, Medicare-only and integrated Medicaid-Medicare plans. The CareSource and ElderServe affiliation addresses these critical long-term care needs to help members be as healthy and independent as possible. Job Summary: The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while promoting quality cost effective outcomes. Essential Functions: • Ensures consistent care along the entire health care continuum by assessing and closely monitoring members' needs and status., • Authorizes covered services and coordinates care regardless of payer., • Collaborates and communicates with member/family/caregivers, primary care practitioners, and the interdisciplinary team., • Works with member/family to maintain the most independent living situation possible, • Assesses, plans and provides continuous care management across all venues of care, including hospital, sub-acute, long-term and home settings., • Regularly assesses members for ongoing eligibility for services based on the specific plan's eligibility criteria., • Performs home visits as required to assess members' living situation, cultural influences, functional and cognitive needs., • Collaborates with the primary care physician and Inter-Disciplinary Team (IDT) to develop the Patient Centered Service Plan for the member., • Ensures appropriate, safe plan for members' discharge from their plan., • Identifies same day grievances, investigates and documents accordingly. Documents any grievance according to plan policy., • Identifies and presents members with complex care management needs or in difficult to manage situations at Intensive Care management meetings (ICM)., • Responds to members' requests in the designated timeframes and completes Initial Adverse Determinations (IAD) as indicated, • Identifies members requiring Care Management Review (CMR), evaluates documentation provided by the IDT including hospital or nursing home discharges planners, and formulates appropriate plan of care., • Documents care management/coordination according to company policy to the specific plan the member is enrolled in, which may include monthly telephonic and in person recertification notes., • Develops efficient plans of care, authorizing only needed services at the most appropriate levels, utilizing network providers and ensuring that services are based on members' needs., • Associates degree in Nursing from an accredited nursing program required, • Bachelor's degree in Nursing preferred, • Three (3) years of experience as a registered nurse required, • Clinical experience in geriatrics and/or managed long-term care experience preferred, • Experience using multiple languages may be required based on operational needs Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel, • Ability to communicate effectively with a diverse group of individuals, • Ability to multi-task and work independently within a team environment, • Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices, • Adhere to code of ethics that aligns with professional practice, • Knowledge of and adherence to Case Management Society of America (CMSA) standards for case management practice, • Strong advocate for members at all levels of care, • Strong understanding and sensitivity of all cultures and demographic diversity, • Ability to interpret and implement current research findings, • Awareness of community & state support resources, • Critical listening and thinking skills, • Decision making and problem-solving skills, • Strong organizational and time management skills, • Bilingual speaking and writing skills are preferredLicensure and Certification:, • Current, unrestricted Registered Nurse licensure in the state of New York required, • Case Management Certification preferred Working Conditions:, • General office environment; may be required to sit or stand for extended periods of time Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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 Location: Hybrid (NYC or Denver) Position Summary: This high-performing individual will be responsible for assisting the product and operational teams in delivering new features and functionality for JUDI, Judi Health's enterprise health platform. Position Responsibilities: • Intake product requests from operations stakeholders and clients., • Triage, research and identifying technical solutions for errors occurring within the JUDI tech stack., • Collaborate with the Product Manager to build business requirements and specifications for road mapped items as directed by the Product Manager., • Responsible for ticket review and identification of missed intent post Quality Assurance review., • Assist Product Manager & team with user experience testing, research, documentation, and stakeholder communication., • Partner with Product Manager to manage backlog and participate in team refinement & planning., • Provide support to the Product Manager and team in terms of planning, roadmap development, and long-term strategy. Minimum Qualifications: • Pursuing a Bachelors degree, • Demonstrable knowledge of SQL, Excel, and other data visualization tools, • Demonstrable knowledge of the Python programming language preferred, • Excellent communication and collaboration skills with ability to translate between technical and not technical audiences both verbally and in writing., • Strong attention to detail and project management skills, • Comfort or experience in a fast-paced, growing environment, • Intellectual and professional curiosity, • Willing to work 35+ productive hours in a work week excluding holidays and approved PTO as measured by various tools when remote. Nothing in this position description restricts management's right to assign or reassign duties and responsibilities to this job at any time. About Capital Rx Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation's electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp, Capital Rx is executing its mission through the deployment of JUDI, the company's cloud-native enterprise health platform, and a Single-Ledger Model, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare. Capital Rx 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. Salary Range$20—$22 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___.

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Even in a non-clinical role, employees have an opportunity to make a positive impact on the quality of our health plan members' lives. Process all requests for services in accordance with Medicare and NYS Medicaid Guidelines as well as departmental criteria and guidelines. Works collaboratively with other disciplines including Care Manager, Assessment Nurse and Primary Care Physician or other Specialists as necessary to ensure timely provision of services. Coordinates timely completion of UAS NY assessment that accurately reflects current condition of the member. Ensures that the member's Individualized Person Centered Care Plan has been updated and accurately reflects present status of the member. • Graduate of an accredited nursing program, Bachelor's preferred, • Knowledge with Utilization management processes preferred, • Current NY RN license and registration required, • CCM preferred, • Minimum three to five years nursing experience in long term care, managed care, home care, geriatrics or hospice, • Prior experience in an interdisciplinary service delivery environment preferred, • Working knowledge of Medicare and Medicaid regulations, • Prior experience in an interdisciplinary service delivery environment preferred, • Working knowledge of Windows, Word and Excel, • Knowledge of current standards of medical practice and healthcare delivery systems, • Strong assessment skills, • Knowledge of Interqual preferred

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Acts as a medical resource to the health plan, directing clinical and government mandated utilization and quality improvement efforts. Responsible for the consistent, effective use of clinical guidelines and clinical nursing rounds. Monitors quality and the appropriateness of medical care. Collaboration on clinical program development in concert with the operational leadership of the plan. • Minimum of 5 years of clinical experience, • Managed Care Experience, • Board Certification in a General Practice, Internal Medicine, Primary Care or Geriatrics, • Practical understanding and strong commitment to managed care, • Knowledge of Quality Assurance, Utilization Review, program development and implementation skills, • Strong communication and leadership skills

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Provide quality cost-effective care to all members by evaluating the need for and pre-authorizing requests for inpatient, outpatient, specialty care, home care, DME, and transportation services, from network and out of network providers, in accordance with departmental criteria and guidelines. managed care nurse, managed care rn, nursing, rn, nurse, care managementGraduate of an accredited nursing program; Bachelor's degree preferred. Minimum of three (3) years experience in medical/surgical nursing Working knowledge of utilization management processes. Knowledge of Federal and State managed care regulations. Prior managed care experience preferred. Working knowledge of Windows, Word, Excel. Licensed to practice as a registered nurse in the state of New York with current registration. CCM preferred. Knowledge of current standards of medical practice. Ability to solve problems through the application of nursing theory and processes. Excellent written and oral communication skills. Knowledge of current standards of the healthcare delivery system. Ability to set priorities. Ability to work independently while recognizing issues having departmental or organizational impact Ability to work as a team member and facilitate communication among the member, healthcare providers, community and medical management staff. Elderplan in order to meet the healthcare needs of the member.

Multiple Openings Description of Duties: • Present to, follow up and sell Individual Medicaid, Essential Plan, QHP and CHP products on a direct sales basis. Assist and enroll individuals by completing the appropriate application forms, obtain required documentation necessary for enrollment, and meeting necessary enrollment targets., • Conduct home visits and other appointments as needed to complete the application and obtain all required documentation., • Develop and maintain appropriate understanding of the health care products related to sales responsibility. Successfully complete periodic certification and testing to maintain knowledge level established by regulations., • Maintain appointments, develop community marketing sites, establish relationship with community based organizations, Participate in health related activities / special events including evening and weekend activity, create self-generated leads, and provide services to walk-ins. Obtains feedback from referral sources and prospective enrollees., • Stimulates word-of-mouth referrals from participants, prospects and their families., • Utilize automated tools to perform individual enrollment duties., • Refer all existing members up for recertification to Retention Specialist when applicable., • Perform recertification activities when necessary., • Function as a liaison between all EmblemHealth departments to help identify and capture prospect's problems or concerns. Work with Neighborhood care team to maintain and improve EmblemHealth's image as a High Quality and Affordable health plan in the community., • Assist members with selecting a Primary Care Physician (PCP) using the provider directory., • Present EmblemHealth insurance products and benefit plans to community groups, small businesses and other prospective subscribers., • Develop and execute sales plan which focuses on growth of the individual products in the assigned neighborhood. Maintain and grow book of enrollments. Enrollment activities include on-site coverage at hospitals, provider offices, City agencies, community business partners and Community Based Organizations (CBO's). All activity entered into Salesforce tool., • Performs other duties as assigned or required, • Regular attendance is an essential function of the job. Qualifications:, • High School Diploma or equivalent required, • 4 years of relevant sales experience preferred, • Driver's License and automobile with appropriate coverage is required for territories - Long Island, Staten Island, Westchester, etc., • Travel in the New York metropolitan area required, • Must be able to work nights and weekends as required, • Excellent interpersonal and presentation skills and the ability to work independently., • Excellent organizational and communication skills, both verbal and written, • Ability to develop strong relationships and influences in the community, • Ability to input and update data in database system, • Works independently and produces Self-Generated leads, • Ability to multi-task, • Successful completion of annual product training and testing to maintain regulatory certification Additional Information, • Requisition ID: 25048, • Hiring Range: $50,000 - $60,000

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. An employee in this role provides telephonic assessments of members' medical, psychosocial, physical and spiritual needs. He/She develops, implements, and monitors person centered service plan, and ensures continuity of care across all healthcare settings by collaborating with the interdisciplinary team, PCP, member/member's representatives, and specialists. Utilizes benefit structure and community-based resources to meet member's needs. Educates members on disease processes, preventative health, and quality of life interventions. SW Care Manager will be knowledgeable in and adhere to CMS/DOH regulations and policies. • Bachelor's degree social work or related field required, MSW or LMSW preferred., • Minimum three to five years clinical social experience in long term care, managed care, home care, geriatrics or hospice preferred., • Prior experience in an interdisciplinary service delivery environment preferred., • Working knowledge of Medicare and Medicaid regulations preferred., • Prior experience in an interdisciplinary service delivery environment preferred., • Current LMSW in New York State preferred.

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Provides quality, cost-effective care to all members through the direct supervision of staff responsible for the management and coordination of the member's care through the incorporation of interdisciplinary strategies, medicare regulations, and medically accepted standards of care. Supervises the assessment of all acute and sub-acute inpatient care for appropriateness of setting and services, according to pre-established criteria and guidelines and ensure a 95% compliance or greater. Supervises the assessment and coordination of the members physical, psychosocial and discharge planning needs through communication with appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners. Assures appropriate staffing to support departmental/agency services. Ensures all employees are oriented to their department/agency and job and provided with appropriate training, development and continuing education. Correctly interprets and applies all Human Resources policies and procedures relative to discipline, recruitment and selection, performance appraisals, salary reviews and staffing.Bachelor's Degree in Nursing. Minimum one to three years previous management experience preferred. Previous managed care experience in the areas of utilization management and/or case management required. Working knowledge of Windows, Word, Excel. Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies.

Multiple Openings Description of Duties: • Present to, follow up and sell Individual Medicaid, Essential Plan, QHP and CHP products on a direct sales basis. Assist and enroll individuals by completing the appropriate application forms, obtain required documentation necessary for enrollment, and meeting necessary enrollment targets., • Conduct home visits and other appointments as needed to complete the application and obtain all required documentation., • Develop and maintain appropriate understanding of the health care products related to sales responsibility. Successfully complete periodic certification and testing to maintain knowledge level established by regulations., • Maintain appointments, develop community marketing sites, establish relationship with community based organizations, Participate in health related activities / special events including evening and weekend activity, create self-generated leads, and provide services to walk-ins. Obtains feedback from referral sources and prospective enrollees., • Stimulates word-of-mouth referrals from participants, prospects and their families., • Utilize automated tools to perform individual enrollment duties., • Refer all existing members up for recertification to Retention Specialist when applicable., • Perform recertification activities when necessary., • Function as a liaison between all EmblemHealth departments to help identify and capture prospect's problems or concerns. Work with Neighborhood care team to maintain and improve EmblemHealth's image as a High Quality and Affordable health plan in the community., • Assist members with selecting a Primary Care Physician (PCP) using the provider directory., • Present EmblemHealth insurance products and benefit plans to community groups, small businesses and other prospective subscribers., • Develop and execute sales plan which focuses on growth of the individual products in the assigned neighborhood. Maintain and grow book of enrollments. Enrollment activities include on-site coverage at hospitals, provider offices, City agencies, community business partners and Community Based Organizations (CBO's). All activity entered into Salesforce tool., • Performs other duties as assigned or required, • Regular attendance is an essential function of the job. Qualifications:, • High School Diploma or equivalent required, • 4 years of relevant sales experience preferred, • Driver's License and automobile with appropriate coverage is required for territories - Long Island, Staten Island, Westchester, etc., • Travel in the New York metropolitan area required, • Must be able to work nights and weekends as required, • Excellent interpersonal and presentation skills and the ability to work independently., • Excellent organizational and communication skills, both verbal and written, • Ability to develop strong relationships and influences in the community, • Ability to input and update data in database system, • Works independently and produces Self-Generated leads, • Ability to multi-task, • Successful completion of annual product training and testing to maintain regulatory certification Additional Information, • Requisition ID: 2502E, • Hiring Range: $50,000 - $60,000

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. The manager will coordinate multiple projects, oversee day-to-day staffing, and administer all standard operating procedures. Operational Data Store • Under guidance of Director, oversee project management for all operational data store activities., • Work closely with Analysts to create new functional specifications for enhancements or to improve existing logic based on changing business needs., • Owner of change control process and documentation for each approved modification., • Oversee test plan development, documentation and implementation process., • Under guidance of Director and in collaboration with business owners, manage projects and prioritize all new reporting needs for daily on-demand and auto-delivered data., • Identify ad-hoc reporting that can be converted to standardized reporting for enhanced automation and increased efficiency., • Recommend technological enhancements for improved standardized reporting. Monitor Staff Productivity and System Performance • Obtain functional requirements from business users on how they want to monitor staff productivity. Prepare confidential reports to fulfill this need., • Time extracts and reports to oversee the length of time required for each. Merge with overall system performance metrics to provide recommendations to senior leadership. We truly value our staff and further acknowledge their contributions by offering:, • Employee and family health coverage, • Competitive salaries, • Employer contributed pension plan, • Generous time off, • Tuition reimbursement, • 403(b) retirement plan Bachelor's Degree in Statistics, Economics, Business or other related field required. Graduate Degree (MBA or CPA) in Statistics, Healthcare, Economics or Business preferred. 5 years experience in Healthcare Economics, Statistics, Data Analysis, Financial Reporting, Actuary, Managed Care, and/or Long Term Care operations experience required. Medicare and/or Medicaid Managed Care experience required. Experience with regulatory reporting required. Knowledge of CMS & NYS DOH regulations preferred. Experience calculating IBNR, BCR (Benefic Cost Ratios) and other metrics preferred. Experience formulating MMCOR and encounter data preferred. Experience developing rate filings including Medicare Advantage Part C & D and MLTC preferred. Management experience preferred. Excellent organizational skills. Ability to work on multiple projects. Excellent Word, Excel, Access, Project, Visio skills. Excellent SQL Server 2008R2 (or better) skills with Reporting Services preferred.

Summary of Position Lead and drive high value Behavioral Health strategy and initiatives along with Behavioral Health clinical leader. Execute an organizational strategic plan for behavioral health. Identify areas for improvement, implement innovative solutions, and optimize processes to enhance efficiency, quality, and cost-effectiveness of behavioral healthcare. Collaborate with cross-functional teams, analyze data, and develop strategies to streamline operations and drive continuous improvement in behavioral health. Principal Accountabilities • Develop and execute the enterprise behavioral health strategy across all lines of business (Medicare, Medicaid, Commercial)., • Serve as operational lead in supervising Behavioral Health (BH) vendor, taking responsibility over Carelon and services provided by them to our members., • Support integration between behavioral health and physical health to support whole-person care., • Partner with internal operations, network, and analytics teams to design efficient workflows, reduce administrative burden, and enhance member outcomes., • Oversee performance of internal and delegated behavioral health operations including care management, appeals/grievances, and quality reporting., • Lead continuous improvement initiatives focused on access, timeliness, and member engagement., • Monitor key performance indicators (PMPM cost, utilization, readmission rate, engagement rate) and drive accountability for results., • Drive Performance improvement initiatives for access, quality and affordability., • Monitor NYS-required settlement activities around service delivery and quality of patient satisfaction to ensure that providers in-network., • Develop and lead behavioral health initiatives with leadership clinical and executive leadership., • Support the innovation agenda for behavioral health, identifying and implementing emerging models of care, digital solutions, and community-based partnerships., • Support the development of EmblemHealth's Behavioral Health member journey, optimizing access and member satisfaction. Develop complaint processes for members and providers with appropriate monitoring and mitigation of any ongoing issues., • Determine and manage the effectiveness of EmblemHealth's behavioral health provider directory, maintaining the effectiveness of response to continual service evaluation., • Direct provider manual adjustments and updates as well as member-facing content adjustments., • Define key evaluation metrics for behavioral health program and manage outcomes across teams., • Provide Behavioral Health thought leadership to plan and external stakeholders., • Collaborate with Provider Network Management & Quality Management to design and operationalize new value-based model(s) with network providers., • Manage & participate in various provider-facing Joint Operating Committee meetings with BH providers., • Represent behavioral health externally and in appropriate regulatory meetings., • Participate in behavioral health committees as well as participate in various cross functional committees., • Establish and maintain continuity in the planning, development and implementation of policies, operational processes, workflows required to execute organizational strategies and to assure consistency in process application throughout Care Management., • Bachelor's degree required; graduate degree in related field preferred, • 10 - 12+ years of relevant, professional work experience, including 5+ years in the healthcare insurance industry, • Excellent understanding of Behavioral Health clinical & operations and business needs, • Experience with project leadership and management, including planning, execution, and monitoring projects, • Strong communication skills (verbal, written, interpersonal) to collaborate effectively with cross-functional teams and stakeholders; ability to drive collaboration and foster highly productive, functional relationships, • Demonstrated agility and ability to drive program completion in expedited timelines, • Excellent analytical and problem-solving skills, with the ability to interpret data and make data-driven decisions, • Proven experience in leading process improvement initiatives and driving change within a healthcare organization, • Ability to adapt to a fast-paced and evolving healthcare environment Additional Information, • Requisition ID: 1000002860, • Hiring Range: $113,400-$210,600

AdvantageCare Physicians (ACPNY) is a primary and specialty care practice serving half a million patients across the New York metropolitan area. With more than 30 medical offices across New York City's five boroughs and Long Island, ACPNY is continually expanding our practice and enhancing our services for communities throughout New York. As we grow, our employees grow with us. Summary of Position We are seeking an experienced Internal or Family Medicine trained physician to join us in pursuit of high-quality patient care to provide a full scope of primary care services including but not limited to diagnosis, treatment, coordination of care, preventive care and health maintenance. The Ideal Candidate: • Must have a minimum of two to three years of primary care clinical experience in an outpatient setting., • Ability to diagnose and treat a wide variety of chronic conditions and improve patient outcomes., • Demonstrate competency in diagnosis and treatment to assure high standards of patient care and safety are maintained., • Patient-centered approach toward a positive patient experience., • Excellent communication skills., • Interest in Population Health Management. Principal Accountabilities • Review patient's history and perform physical examinations. Evaluate, diagnose and provide appropriate treatment and patient care. Refer patient to specialist as needed., • Prescribe medications and formulate ongoing treatment and disease management plans., • Provide relationship-centered care, considering the patient's psychosocial and physical needs., • Collect and record patient information, such as medical histories, reports and examination, • results. Maintain complete and accurate medical records., • Communicate effectively with the clinical team to insure total delivery of quality care., • Participate in medical staff educational programs and meetings. Qualifications Education, Training, Licenses, Certifications • Doctor of Medicine (MD), Doctor of Osteopathy (DO) or foreign equivalent Relevant Work Experience, Knowledge, Skills, and Abilities • Relevant Work Experience, Knowledge, Skills, and Abilities, • Seeking experienced providers, • Board Eligible/Board Certified in Internal Medicine or Family Medicine, • Must possess current, unrestricted New York State license., • Must possess active Drug Enforcement Agency (DEA) registration or be eligible for registration, • Must possess active Medicare/Medicaid Enrollment or be eligible to enroll, • BLS or ACLS required., • Requisition ID: 1000003019, • Hiring Range: $250,000-$280,000

Summary of Job Support the Quality Management department in the development and maintenance of a monitoring and reporting structure for data reports and analysis related to the HEDIS-QARR project, pharmacy adherence initiatives, and other performance improvement initiatives related to Medicare Stars and Medicaid QIA. Provide analysis of HEDIS-QARR projects, pharmacy adherence initiatives, and other performance improvement initiatives related to Medicare Stars and Medicaid QIA. Develop meaningful insights and actionable analytics using advanced statistical and/or modeling analyses to drive quality and STARS performance. Responsibilities • Analyze monthly rate reports and stratify data to identify statistically significant trends., • Evaluate effectiveness of complex quality improvement projects established for all Medicare and state-sponsored programs., • Create reports to track, monitor and report on provider and network-wide quality performance, including performance towards Medicare Stars and NYSDOH quality goals., • Perform exploratory and in-depth data analyses for assigned measure/population and develop complex predictive models utilizing independent variables and programming language., • Identify data improvement opportunities through review of HEDIS/QARR/Star reports and data outputs and detecting data acquisition, capture, and system error issues., • Provide analytical and technical support in the design, development and maintenance of quality improvement and wellness-based initiatives., • Work with various teams in Quality Management to develop needed tools to track, trend and directly impact measures results related to Quality Scores., • Perform regular rate/impact /trending analysis and recommend corrective actions to meet quality targets., • Maintain up-to-date knowledge and understanding of HEDIS/QARR/Star measure technical specifications., • Support quality specific interoperability efforts., • Bachelor's Degree in an analytical/quantitative field (healthcare management, finance, business, mathematics, engineering, applied stats/economics, or related)., • Master's Degree (Preferred), • 4 - 6+ years of relevant, professional work experience in an analytical role (Required), • 2+ years of managed care/healthcare experience (Preferred), • Proficient in MS Office - Word, PowerPoint, Excel, Access (Required), • Advanced experience with relational database applications - SAS, R, SQL, or others (Required), • Experience with improving or automating processes using programming languages/software - Python, VBA, R, SAS, C++, etc. (Required), • Experience with and proficient in statistical software/programs - SAS, R, Stata, Minitab or others (Required), • Familiarity with Business Intelligence tools - Tableau, Power BI (Preferred), • Knowledge of HEDIS and Medicare Stars reporting processes (Preferred), • Strong communication skills - verbal, written, presentation, interpersonal (Required) Additional Information, • Requisition ID: 1000002938, • Hiring Range: $68,040-$118,800

Summary of Position • Provide support and assistance to mainstream Medicare, Medicaid, HARP, Child Health Plus and Essential members telephonically (inbound and outbound) with a variety of non-clinical healthcare and membership needs: completing health care gaps, health related assessments, and state required applications to ensure continuous eligibility of healthcare coverage., • Facilitate and aid Medicaid, HARP, CHP members as NYS Certified Application Counselor with state redetermination process including educating members on state qualifications, necessary proof of income and associated documents while completing required applications and submission to the state., • Proactively lead, facilitate, and assess member experience through targeted Medicare member outreach, including members with multiple complex issues, grievance and appeal cases as well as access to care challenges to continually improve healthcare performance and consumers assessment of EH ability to provide high quality services., • Navigate and provide direction and guidance during member interactions utilizing extensive knowledge of EmblemHealth's products, complex processes, and multiple systems to enhance member's health journey., • Provide seamless care coordination and individual needs assessments from member onboarding and throughout member lifecycle to support Medicare, Medicaid, HARP, and CHP members with care/risk health gaps and health risk assessment., • Provide member assistance with initial and annual health assessments., • Identify members qualifying for Care Management programs and resources and collaborate through referrals to Care Management Team., • Assist, coordinate and schedule members with primary care and specialty visits, tests and necessary screenings., • Intermediary and professional liaison with member and healthcare providers and provider facilities., • Meet state mandated deadlines maintaining and acting with a sense of urgency., • Facilitate and aid Medicaid, HARP, CHP members as NYS Certified Application Counselor with New York State of Health redetermination process including educating members on state qualifications, necessary proof of income and associated required documents while completing application and submission to the state., • Lead and facilitate complex application issues including mixed immigration status households, multi-tax household, family enrollment issues and complex income situations., • Intermediary and professional liaison with the member and New York State of Health for coverage redeterminations including handling and submitting sensitive member information., • Proactively lead, facilitate, and assess member experience through targeted Medicare member outreach, including members with multiple complex issues, grievance and appeal cases as well as access to care challenges to continually improve healthcare performance and consumers assessment to provide high quality services., • Provide guidance, advice, and direction; and engage team members to solve for member issues., • Collaborate and provide feedback to Director of Customer Retention and Loyalty team to understand member pain points and identify opportunities to mitigate., • Onboard newly state assigned members and serve as guide for member plan and benefits. Set member expectations and enroll members in EH value added services including Member Portal, Member Rewards, Auto Pay while identifying member communications preferences including paperless., • Retain members targeted for termination of plan by New York State of Health. Assist and educate members on next steps, required paperwork; and institute temporary plan extensions for resolution., • Retain members targeted for termination of plan due to lack of premium payment. Assist member in payment options and avoid loss of coverage., • Support goals of the department by meeting quarterly with Customer Retention and Loyalty leadership team to review results and discuss ways to continually improve member satisfaction, loyalty, revenue (Quality and Risk Scores) and reduce costs., • Participate in weekly meetings with manager and team members to discuss customer concerns, improvement opportunities (people, processes, and technology), and other company priorities., • Assist, support, and conduct user acceptance testing as appropriate and outside of normal business hours., • Participate in state meetings as needed., • Ongoing learning of EmblemHealth and Connecticare products and services, including any recent changes in business rules or decisions that may impact customer experience., • Perform other duties assigned, directed, or required, • Bachelor's Degree, • Additional experience/specialized training may be considered in lieu of degree requirements required, • Must have NYS Certified Application Counselor certification; or obtain certification within 90 days of hire date as a condition of continued employment. Must maintain up-to-date, valid certification status to remain employed in the role., • 3 - 5+ years of experience working with members in customer service, medical or managed care environment required, • Experience communicating directly with customers, assessing needs, and connecting customers with resources required, • Knowledgeable on how to navigate all aspects of medical care and managed care system; health and wellness preferred, • Knowledge of healthcare related regulations, processes, services, and products preferred, • Ability to demonstrate excellent service knowledge and hospitality required, • Technologically savvy, with the ability to quickly learn and navigate different information technology systems required, • Flexibility to travel to, and work in a physical office site when needed required, • Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.) required, • Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience required Additional Information, • Requisition ID: 2504M, • Hiring Range: $52,000-$92,000

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. The Assistant Director of Medicaid and Integrated Products is primarily responsible for guiding the planning, execution, and administration of Medicaid Managed Care, as well as supporting the MLTC & Integrated Products lines of business. Core responsibilities include assisting in the direction of product ideation, development, implementation, and continuous improvement; competitive landscape analyses and market trend monitoring in New York and regional areas; supporting the identification & development of member growth & retention strategies; leading high-visibility, cross-functional product initiatives and regulatory implementations, and overseeing the development of regulatory Medicaid member materials. The successful candidate will also co-lead Federal and State policy and regulatory analysis impacting Medicaid products, and leverage analytics to support ongoing advocacy and/or product performance monitoring. Product Strategy and Innovation • Serves as Medicaid Product SME to internal operational, technical, regulatory, clinical, and other cross-functional teams to support the exploration, coordination, and implementation of new Medicaid products, service area changes, and/or benefit designs, DOH and/or CMS required regulations, and/or strategic improvement initiatives., • Evaluates, develops, and builds new offerings within Medicaid and integrated benefits program including liaising with cross-functional stakeholders and government agencies on regulatory submissions, regulatory communications, readiness reviews, and overall product build & ongoing implementation., • Develops and leads systematic competitive intelligence monitoring and tracking such as benefit design and vendor utilization, product/plan offerings, membership and enrollment trends, service area modifications, mergers and acquisitions, and marketing and promotion efforts., • Conduct in-depth research on business and market trends, product analyses, and competitive intelligence to leadership teams for strategy development. Federal and State Regulatory and Policy Analysis & Oversight • Monitor and track Federal and State policies & regulations that impact Medicaid and integrated benefit products across contractual obligations, eligibility, enrollment, marketing, benefits offering, utilization management, and other areas., • Analyze and interpret CMS and State contractual requirements and updates across all products (e.g., model contracts, state Medicaid agency contract), • Assess and evaluate Federal and State regulatory and policy impacts on products' growth and operations, and summarize risks or opportunities with business stakeholders in plan-wide forums., • Support internal leadership and external audiences (e.g., government agencies, association groups) in defining advocacy points, recommendations or suggestions in response to proposed regulations or policies, and coordinate responses to the State on behalf of the organization, • Lead and/or support Medicaid, Managed Long-Term Care, and Integrated Product regulatory reporting, • Reviews member communications and coordinate with internal teams to ensure regulatory compliance and implementation according to Medicaid managed care requirements. Product Analytics and Optimization • Partners with internal departments to ideate and evaluate product metrics (enrollment, disenrollment, Medicaid recertification, member experience and interaction, benefit utilization, demographics, risk scores, and others) to support ongoing product performance and identify areas of opportunity., • Identifies member and provider abrasion points based on product offerings, and proactively initiates cross-functional projects to improve member and provider experience, workflows, or marketing awareness., • Proactively initiates and leads projects to support member growth and retention including developing business case and scope, defining project parameters, implementation requirements (operational and technical), and evaluation metrics to evaluate success. Support Organization and Departmental goals • Tracks overall Product Initiatives Dashboard to monitor team capacity, resource tracking, and overall progress towards company and departmental goals., • Collaborates with Director to support product changes, strategic performance improvement initiatives, regulatory compliance and auditing, policy & procedure development, and ongoing management of product operations., • Coordinates all phases of a project lifecycle including but not limited to initiation, project plan development and management, execution, control and quality assurance management, post-implementation monitoring, overall project documentation, and project close out and hand-off., • Represent Elderplan/HomeFirst and Medicaid & Integrated Products team in government agency meetings, or external meetings with providers and advocates., • Completes adhoc tasks and assignments as requested., • Utilizes corporate services resources such as Human Resources, Compliance, Legal, Finance, Information Services, Marketing, etc., as appropriate., • Interviews and participates in the selection process for qualified staff in collaboration with Human Resources and department management., • Bachelor's degree required. Graduate degree in business, health administration, public policy or related area preferred., • Minimum of five years of heath plan experience is required, with core experience in Medicaid Managed Care and in any of the following disciplines: Product development & management, Quality, Clinical Strategy & Operations (UM/CM), Health Economics, Finance, Health Plan Operations, or health care industry/healthcare consulting., • Minimum of 2-3 years of managerial experience., • Requires in-depth knowledge of Medicaid Managed Care program, preferably in the New York market, and CMS/State regulations across key areas such as benefit offerings, eligibility and enrollment, quality, utilization management, care management, regulatory and compliance, finance and health economics., • Demonstrated ability to initiate, plan, implement, and project manage high-visibility, cross-functional initiatives to successful completion., • Requires ability to read complex statutes and regulations and interpretation to identify operational, financial, or regulatory risk., • Strong and proactive work ethic, attention to detail, effective time management, and commitment to developing quality work quickly., • Can critically interpret and synthesize key data for leadership and business stakeholders to inform and influence decision-making., • Strong public speaking and oral and written communication skills., • Advanced Microsoft Word, PowerPoint, Excel skills.

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Even in a non-clinical role, employees have an opportunity to make a positive impact on the quality of our health plan members' lives. Process all requests for services in accordance with Medicare and NYS Medicaid Guidelines as well as departmental criteria and guidelines. Works collaboratively with other disciplines including Care Manager, Assessment Nurse and Primary Care Physician or other Specialists as necessary to ensure timely provision of services. Coordinates timely completion of UAS NY assessment that accurately reflects current condition of the member. Ensures that the member's Individualized Person Centered Care Plan has been updated and accurately reflects present status of the member. • Graduate of an accredited nursing program, Bachelor's preferred, • Knowledge with Utilization management processes preferred, • Current NY RN license and registration required, • CCM preferred, • Minimum three to five years nursing experience in long term care, managed care, home care, geriatrics or hospice, • Prior experience in an interdisciplinary service delivery environment preferred, • Working knowledge of Medicare and Medicaid regulations, • Prior experience in an interdisciplinary service delivery environment preferred, • Working knowledge of Windows, Word and Excel, • Knowledge of current standards of medical practice and healthcare delivery systems, • Strong assessment skills, • Knowledge of Interqual preferred

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Even in a non-clinical role, Elderplan employees have an opportunity to make a positive impact on the quality of our health plan members' lives. The Wellness Outreach Specialist plays an integral role in improving the health outcomes of Elderplan members. The Specialist is responsible for facilitating and implementing outreach activities, special events, programs, and presentations which support member education and health plan awareness. The Specialist also supports the Senior HEDIS Coordinator during Hedis season. • High school Diploma or equivalent, required; Bachelor's degree, preferred, • Previous (3-5 years) customer service experience required, • Previous experience working with the Medicarepopulation preferred, • Basic knowledge of Microsoft Word, Microsoft Excel, RightFax, Care Management System

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Handle all provider file update requests received from participating providers in accordance with the established timeline while developing and maintaining positive provider/customer services. You will be asked to coordinate with various Elderplan departments and NPO teams to ensure provider file update requests and demographic-related claim denial inquiries are handled appropriately while balancing provider needs with Plan priorities. In addition, you will handle and organize correspondence from non-par providers under the file update process for the Data Maintenance Team as needed. You will communicate the receipt/completion of all file update correspondence received from provider/ designee in a timely and consistent manner. Other duties will involve educating participating providers regarding any updates to the processes and escalating any issues to the Provider Relations/IPA, among other teams. • High School diploma, • Bachelor's degree preferred, • With Bachelor's degree; minimum of one year of experience in Managed Care, provider billing, and/or customer service., • Without Bachelor's degree, minimum of three (3) years of experience, as above, • Knowledge of Microsoft Office

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Even in a non-clinical role, Elderplan employees have an opportunity to make a positive impact on the quality of our health plan members' lives. The Business Operations Analyst provides support to the Network Provider Operations department with daily operations, project initiatives, system updates, special projects, and all regulatory reporting and analysis. The Analyst will audit departmental operations with a focus on data integrity, improving accuracy, and identifying training opportunities for department. Responsible for preparation and submission of all Provider Network Regulatory Reporting. Develop and run extracts to support departmental operational reporting. Lead system upgrades and implementations for the department, and provide technical support as needed. Collaborate with existing technical EPIS structure. • High school diploma, • Asociates Degree or Bachelors Degree in health/business related field preferred, • 3-5 years of experience in a managed care environment, • Experience with working with technology, systems, provider and/or claims data, • Experience with data, trending, and qualitative analysis, • Familiarity with Medicaid and Medicare regulations, • Experience with geo access analysis and regulatory reporting, • Experience with generating files and reviewing quality for provider directories, • Required: Microsoft Word, Excel, Access, and Visio. SQL., • Preferred: Visual CACTUS, HealthRules Payor, Quest Analytics, and Optum GeoAccess Suite, • Knowledge of provider data entry and credentialing process, • Ability to utilize Access and SQL to program and execute queries to support data structure and analysis, including tracking and trending on errors, • Excellent verbal and written communciation skills, • Ability to evaluate system set-up and files to determine whether changes are needed to process correctl, • Ability to handle multiple deliverables and to meet strict reporting timeframes, • Knowledge of NY regulatory reports

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Process requests for selected elective services, out of network requests, out of area requests and durable medical equipment in accordance with departmental criteria, regulatory standards, and Medicare guidelines. Communicates all elective hospital admissions to the appropriate Utilization Management Coordinator and/or Care Manager to ensure timely receipt of information and continuity of member care. Ensures that authorizations are appropriate, and determinations are made and documented to facilitate claims processing, integrity of data record, and to minimize unnecessary retrospective review. Applies program criteria to identify members for Care Management and Geriatric Case Management during the pre-authorization, concurrent review, and discharge planning process. Graduate of an accredited Practical Nursing Program; current LPN NY license and registration required. Minimum of 1-3 years Medical/Surgical nursing experience; prior managed care experience preferred; familiarity with Utilization management processes preferred. Working knowledge of Windows, Word and Excel. Knowledge of current standards of medical practice and healthcare delivery systems. Excellent written and oral communication skills. Good analytical abilities.