Managed Care Coordinator

MJHS; New York (NY); On-site; USD 60,000 - 90,000; Full time

Job summary

MJHS Health System seeks a Care Manager to support Elderplan members through coordination of ISNP, IESNP and Elderplan Plus services, ensuring high quality, cost-effective care in line with regulatory requirements.

The role emphasizes strong communication and organizational skills, with experience in managed care and utilization management preferred, and a focus on coordinating care between facilities and home settings in the New York area.

Qualifications

• High School Diploma or equivalent required; college degree preferred.
• One-year prior managed care experience preferred.
• Prior experience in a health care setting preferred.
• Familiarity with utilization management and case management.

Responsibilities

• Coordinate care for Elderplan members in ISNP, IESNP and Elderplan Plus programs in compliance with departmental and regulatory requirements.
• Support care management and clinical services to deliver high-quality, cost-effective member care.

Skills

Managed care experience

Healthcare experience

Utilization management

Case management

Education

High School Diploma or equivalent

College Degree preferred

Job description

Come lead with us at New York, NY

Rooted in Jewish values and traditions, and consistent with the highest standards of quality care, MJHS Health System is a premier provider of health services in the greater metropolitan area and beyond, ensuring access to health, supportive and community-based services across the continuum of need. Our MJHS Medical Associates, P.C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide care to Elderplan members who are residents of assisted living and long term care facilities, as well as to those living at home.

Ensure high quality, cost-effective care and services for Elderplan members through support of professional Care Management and/or Clinical Service activities. This position supports all aspects of care coordination for our ISNP, IESNP and Elderplan Plus members in compliance with all departmental and regulatory requirements.

The position requires excellent communication and organizational skills.

• High School Diploma or equivalent; College Degree preferred
• One-year prior managed care experience preferred
• Prior experience in a health care setting preferred
• Familiarity with utilization management/case management