Care Coordination Specialist – Managed Care

MJHS; New York (NY); Sur place; USD 60 000 - 80 000; Plein temps

Résumé du poste

MJHS in New York, NY is seeking a Care Management Coordinator to ensure high-quality, cost-efficient care for Elderplan/HomeFirst members. The role supports care coordination for Medicaid and dual products, acting as a liaison between members, the care management team, and vendors.

The position requires excellent communication and organizational skills, with responsibilities including processing enrolled cases, handling service requests, coordinating pre-authorizations, and providing data entry

Qualifications

• 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.

Responsabilités

• Process all newly enrolled cases per EP/HF workflows and maintain member files.
• Handle requests about covered/non-covered services and supplies.
• Handle initial requests for pre-authorization of services and supplies.
• Coordinate and provide service authorizations to vendors.
• Accurate data entry per departmental workflows.
• Participate in scheduled team meetings.

Connaissances

Communication skills

Organizational skills

Data entry

Team coordination

Interdepartmental liaison

Formation

High School Diploma or equivalent

College degree preferred

Description du poste

MJHS in New York, NY is seeking a Care Management Coordinator to ensure high-quality, cost-efficient care for Elderplan/HomeFirst members. The role supports care coordination for Medicaid and dual products, acting as a liaison between members, the care management team, and vendors.

The position requires excellent communication and organizational skills, with responsibilities including processing enrolled cases, handling service requests, coordinating pre-authorizations, and providing data entry