Care Management Coordinator: Medicaid Services Liaison

MJHS; New York (NY); Vor Ort; USD 60.000 - 80.000; Vollzeit

Zusammenfassung

MJHS’s Elderplan and HomeFirst programs in New York, NY seek a Care Management Coordinator to ensure high-quality, cost-effective care for Medicaid/dual members. You will support care coordination activities, liaise with members, the care management team, and vendors, and help maintain CMS/DOH compliance.

The role requires strong communication and organizational skills, with prior managed care experience and healthcare setting familiarity valued.

Qualifikationen

• One year of managed care experience required.
• Familiarity with utilization management/case management.
• Experience in a health care setting preferred.

Aufgaben

• Process newly enrolled cases per established Care Management workflows and maintain member files.
• Process requests and inquiries about covered vs non-covered services/supplies.
• Handle pre-authorization requests for services and supplies.
• Coordinate and provide service authorizations to vendors.
• Provide accurate and timely data entry per departmental workflows.
• Participate in scheduled team meetings.

Kenntnisse

Managed care experience

Utilization management

Care coordination

Ausbildung

High School Diploma or equivalent

College degree preferred

Jobbeschreibung

MJHS’s Elderplan and HomeFirst programs in New York, NY seek a Care Management Coordinator to ensure high-quality, cost-effective care for Medicaid/dual members. You will support care coordination activities, liaise with members, the care management team, and vendors, and help maintain CMS/DOH compliance.

The role requires strong communication and organizational skills, with prior managed care experience and healthcare setting familiarity valued.