Senior Clinical Eligibility Lead: Care Coordination

Healthfirst, Inc.; New York (NY); On-site; USD 122,900 - 188,020; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Life insurance

401k contributions

Incentive programs

Job summary

Healthfirst, Inc. is looking for a Senior Manager of Clinical Eligibility to lead the Assessment team's efforts in enhancing population health for Medicaid and Medicare programs. This role involves conducting member and family education, managing personnel, and ensuring timely assessments. The ideal candidate is an NYS licensed RN with experience in managed care and strong interpersonal skills. The position offers a competitive salary range ($122,900 - $188,020 for the Greater New York City Area) and comprehensive benefits.

Qualifications

• Knowledge of state and federal regulations relevant to various programs.
• Experience with managed care organizations or long-term care environments.
• Supervisory, training, or management experience is preferred.

Responsibilities

• Manage Assessment Managers for timely assessments and interventions.
• Ensure compliance with SHP standards and DOH regulations.
• Coordinate with interdisciplinary teams for effective care planning.

Skills

Interpersonal skills

Communication skills

Time management

Problem solving

Cultural sensitivity

Leadership skills

Education

NYS licensed RN

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Microsoft PowerPoint

Microsoft Access

Adobe

Visio

Project management

Job description

Healthfirst, Inc. is looking for a Senior Manager of Clinical Eligibility to lead the Assessment team's efforts in enhancing population health for Medicaid and Medicare programs. This role involves conducting member and family education, managing personnel, and ensuring timely assessments. The ideal candidate is an NYS licensed RN with experience in managed care and strong interpersonal skills. The position offers a competitive salary range ($122,900 - $188,020 for the Greater New York City Area) and comprehensive benefits.