Managed Care Coordinator

Metropolitan Jewish Health System, Inc.; New York (NY); On-site; USD 65,000 - 85,000; Full time

Job summary

Metropolitan Jewish Health System, Inc. is seeking a Managed Care Coordinator (MCC) to ensure high quality, cost-effective care for Elderplan/HomeFirst members. The MCC supports care management activities and acts as a liaison among members, the care management team, and vendors.

The role requires excellent communication and organizational skills to meet CMS/DOH regulatory requirements and to coordinate care across multiple stakeholders.

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.

Responsibilities

• The MCC is expected to ensure high quality, cost-effective care and services for Elderplan/HomeFirst members in compliance with CMS/DOH regulations.
• Excels in communication and organization to facilitate superior care management and to act as a liaison between members, the care management team, and vendors.

Skills

Care coordination

Managed care experience

Utilization management

Education

High School Diploma or equivalent

College degree preferred

Job description

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.

The Managed Care Coordinator (MCC) is expected to insure high quality, cost-effective care and services for Elderplan/HomeFirst members through support of professional Care Management activities. The position supports all aspects of care coordination for our Medicaid, and/or dual product members in compliance with all departmental and CMS/DOH regulatory requirements. The position requires excellent communication and organizational skills to facilitate superior care management and to act as a liaison between the members, the care management team, and the vendors.

• 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