EmblemHealth Jobs in United States

Perform clinical reviews within the Medical Management Operations Concurrent Review utilization management department. Ensure accurate administration of benefits, execution of clinical policy and timely access to appropriate levels of care. · ...

This role involves leading medical cost transformation initiatives to create self-funded client value, · bending the medical cost curve, and reducing administrative costs. · Establishes medical cost strategies for medium-high valued initiatives using internal/external information ...

The Summer Associate Program allows students to collaborate with senior leaders who are committed to growing, developing and empowering the next generation of healthcare leaders. · ...

The Summer Associate Program allows students to collaborate with senior leaders who are committed to growing, developing, and empowering the next generation of healthcare leaders. · This ten-week paid program gives students the opportunity to work cross-functionally with Informat ...

Work closely with onsite sales colleagues to identify customers in need of enrollment services and provide post sales customer service follow-up. · ...

Play a critical role in delivering the strategic goals of the Community Engagement Team. · ...

Partner with internal teams stakeholders and vendors to evaluate plan and execute strategic business initiatives. Responsible for understanding the technology stack supporting infrastructure and enterprise technical ecosystem and to leverage that knowledge to orchestrate and assi ...

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 ...

We are seeking dynamic professionals to join our call center team. · Key Responsibilities: · Create a connection and develop rapport with members to provide personalized service. · Identify customer needs and assist in providing complete resolution of customer concerns through he ...

We are seeking dynamic Call Center Professionals to join our Call Center in Farmington, CT starting 2026Provide telephonic customer service support to members, providers and facilities. · Bachelors' degree1 – 2+ years of relevant, professional work experience requiredHealthcare e ...

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 eff ...

Physician-Ophthalmology/Retina Staten Island · We are seeking a physician trained in ophthalmology with subspecialty training in medical retina to provide high-quality patient care for diagnosis, treatment, coordination of care, preventive care and health maintenance. · ...

Job Description · The AVP Actuary-Government Business will oversee the development of pricing models and their use in product strategy for Medicare and State-Sponsored Program lines of business. · Lead Enterprise Government Actuarial Areas representing over $2.5 billion in revenu ...

The job involves responsible for the safe and timely transportation of supplies and materials to destinations. · Scout approved parking/event locations within assigned catchment area. · ...

Summary of Position · Provide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face-to-face assessments of members' health care needs, identifying gaps in care and needed support, administering/coordinating imp ...

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 ...

Summary: · * Manage and drive activities related to the development and delivery of the Solutions Architecture domain. · * Collaborate with IT & Business leadership and cross-functional IT teams to drive Enterprise Architecture principals enabling business growth and agility. · ...

REMOTE · Summary: · Provide the analytical resources necessary for the development of overall pricing and reserve setting strategies. · Lead projects to analyze current rate structures and develop improvements and alternatives. · Coordinate the actuarial staff as needed to su ...

Pulmonary Physician Job · AdvantageCare Physicians (ACPNY) seeks a pulmonologist to provide high-quality patient care for adult patients with respiratory tract conditions. · Responsibilities: · Conduct consultations to determine respiratory disease conditions. · Perform comprehen ...

Job Summary · AdvantageCare Physicians (ACPNY) is seeking an Endocrinology trained physician to join our multispecialty group. · ...