Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
AVP, Clinical Implementation - Remote
Qualification:
- Bachelor’s degree in Nursing
- Master’s degree in nursing, clinical area, business administration, preferred
- 10 – 12+ years of relevant, professional clinical operations experience. (R)
- 5+ years of health plan care management experience. (R)
- Strong operational, analytical, and leadership skills. (R)
- Solid understanding of appropriate metrics, measures, and outcomes; ability to work in a data driven environment. (R)
- Thorough understanding of medical information systems, medical claims payment processes, coding, provider contracting approaches, and case management practices. (R)
- Ability to implement change in a consultative approach and maneuver in a matrix reporting environment. (R)
- Experience managing staff, including hiring, training, managing workload and performance. (R)
- Medical management experience. (R)
- Strong understanding of managed care operations and change management. (R)
- Detailed knowledge of New York and/or Connecticut regulations. (R)
- Detailed knowledge of Federal regulations regarding care management services, as well as NCQA accreditation standards for care management. (R)
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
EmblemHealth may provide work visa sponsorship depending on factors such as business unit requirements, position nature, costs, and applicable laws and regulations.