Overview

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.

Responsibilities

Provides daily oversight of the Coordinated Care Support Services Department.  Responsiblities include, but are not limited to staffing, call monitoring, quality assurance/process monitoring, customer problem resolution, enrollment and provider relations. Assists  management of Coordinated Care in creation and implementation of all projects, policies and workflows to ensure full compliance with NYS DOH and CMS regulations. Responsible for outcomes of all service authorizations and nursing documentation processing and assisting in problem solving as new duties arise and volumes fluctuate.  Ongoing monitoring of staff punctuality, attendance and quality of work. 

Qualifications

• Baccalaureate Degree preferred.
• 3 to 4 years’ experience in healthcare.
• 4-5 years experience in business, human services, or a health related field.
• 2 years supervisory experience preferred.
• 2-3 years experience in provider relations and/or member services in managed care.
• Prior experience with Medicaid managed care.
• Knowledge of the service delivery needs of the elderly, chronically ill or disabled.
• Basic computer knowledge with an emphasis on Excel, contact management system, telephony systems and Windows operating systems.

Min

USD $61,463.13/Yr.

Max

USD $73,755.75/Yr.