Medical Management Care Navigator

VNS Health; New York (NY); On-site; USD 32,000 - 40,000; Full time

Benefits offered by this job

Referral bonuses

Generous PTO

Health insurance

Employer-matched retirement savings

Tuition reimbursement

FSAs for healthcare and dependent care

Career advancement opportunities

Internal mobility

Job summary

VNS Health in New York City is seeking a customer service professional to support clinical staff by entering data into the medical management information system, creating case files for services requiring authorization, and ensuring accurate claims adjudication. The role emphasizes strong problem-solving, timely data entry, confidentiality, and collaboration across teams.

Candidates should have a high school diploma, at least two years in customer service, excellent communication, and

Qualifications

• Minimum of two years of customer service experience.
• Excellent oral and written communication skills.
• Advanced PC skills, including Word, Excel or Access.
• Utilization Management experience preferred.

Responsibilities

• Obtains information from doctors/providers and enters data into the MMIS for clinical staff.
• Creates case files for services requiring authorization and maintains accurate data for prompt decisions/claims.
• Delivers strong customer service and triage with accurate data collection and target performance.
• Tracks and reports on customer complaints; identifies trends and suggests corrective actions.
• Provides feedback to leadership regarding training needs.
• Collaborates with management to improve delivery, billing and payment of services.

Skills

Customer service experience

Excellent oral and written comms

Education

High School Diploma or equivalent

Tools

Word

Excel

Access

Job description

VNS Health in New York City is seeking a customer service professional to support clinical staff by entering data into the medical management information system, creating case files for services requiring authorization, and ensuring accurate claims adjudication. The role emphasizes strong problem-solving, timely data entry, confidentiality, and collaboration across teams.

Candidates should have a high school diploma, at least two years in customer service, excellent communication, and