The Director of Quality Management is responsible for the day-to-day implementation, evaluation and continuous improvement of Partners Health Plan, Inc.’s, (PHP) quality assessment and performance improvement (QAPI) program. The Director of Quality Management monitors all…

The Product Manager will support the VP of Operations on all benefit and product implementation, including providing assistance with the monitoring of changes in regulatory requirements impacting operational processes and effectuating those changes such as…

This position serves as the Utilization Management Coordinator for Partners Health Plan’s Medicaid only line of business. The Utilization Management Coordinator works directly with PHP Case Manager(s); CCOs/HHs, and other related entities to review assessments,…

This position serves as the Case Manager for Partners Health Plan’s Medicaid only Line of Business. The Care Preferred Case Manager supports “Care Preferred” members with their need to manage specific health conditions, by general…

The Business Analyst is responsible for the monitoring and/or processing of all corporate grievance and appeals, Medicaid recertification and Other Insurance (COB). This incumbent will also be responsible in the tracking of utilization management activities…

Provides care coordination and non-clinical support functions to PHP participants in accordance with PHPs’ model of care, CMS’s and NYSDOH’s contractual managed care agreements. Member of a two-person team responsible for assisting clinically licensed care…

Provides clinical care coordination services to support PHPs’ model of care as well as CMS’s and NYSDOH’s contractual managed care agreements. This qualified professional is the point person responsible for leading a care coordination team…