Managed Care Coordinator

Metropolitan Jewish Health System, Inc.; New York (NY); On-site; USD 55,000 - 75,000; Full time

Job summary

Metropolitan Jewish Health System, Inc. is seeking a Managed Care Coordinator to ensure high-quality, cost-efficient care for Elderplan/HomeFirst members. The role supports care management activities and coordinates between members, the care management team, and external vendors.

The ideal candidate has a year of managed care experience and familiarity with utilization/case management, with a preference for healthcare setting exposure. This on-site position is based in New York.

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

• Coordinate high-quality, cost-effective care and services for Elderplan/HomeFirst members.
• Support care management activities and serve as liaison between members, care management team, and vendors.

Skills

Managed care experience

Utilization management

Communication skills

Organizational skills

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