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Delegated Vendor Account Manager MJHS Job Description Job DescriptionThe 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 Delegated Vendor Account Manager will provide oversight of assigned delegated contracted vendors for all Elderplan/Homefirst Products. The oversight includes relationship management, contract implementation, analysis and monitoring in accordance with Elderplan’s operational and service goals.
High School Diploma required Bachelor Degree preferred 3 to 5 years of experience in Managed Care Organization(s), Provider Relations and knowledge of provider contracting; or at least 5-8 years of experience in Sales and/or Account Management with demonstrated knowledge of managing and cultivating relationships with new contact and existing business partnerships Knowledge of Microsoft Office, proficiency in Excel and Word is required Critical thinking, ability to absorb, retain and apply a wide range of information about the company, procedural policies and benefits Attention to detail and problem solving skills Ability to interpret a variety of instructions given in written or oral form Evaluate data, summarize and make recommendations for change Excellent oral and written communication skills Excellent time and project management skills; ability to multi-task and prioritize work while working autonomously Experience working with managed care operations with Medicaid and Medicare benefits Ability to interpret contracts for purposes of implementation and monitoring vendor performance New York, NY, USPosted 5 hours ago Enrollment Representative. MJHS 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. New York, NY, USPosted 5 hours ago Hospice Home Health Aide. MJHS The Hospice Health Aide (HHA) is a personal care provider responsible for completing a variety of activities and tasks supporting the care of patients and their families. The HHA is a member of the Hospice Interdisciplinary Team, functioning under the direction and supervision of a Registered Nurse. The HHA demonstrates an understanding of the philosophy, standards, objectives and policies of MJHS Hospice and Palliative Care. Nassau County, NY, USPosted 5 hours ago Mercedes-Benz Technician (All levels of experience should apply) Competition Auto Group At Mercedes-Benz of Smithtown , our auto-technicians are extremely busy and productive. We believe in rewarding excellence with monetary incentives for productivity and education, and we provide ample work, flexible hours, paid training, and advancement opportunities to all of our workers. We're searching for Auto-Technicians who are passionate about professional development, have the ability to control their own earnings potential, and will assist us in providing the high-quality customer care that our clients have come to expect. Saint James, NY, US, 11780Posted 5 hours ago Pharmacy Specialist. MJHS The Pharmacy Specialist will perform duties to support the efforts of Elderplan Pharmacy Department in the development, coordination, and maintenance of the plan’s pharmacy program. These duties involve administrative tasks and outreach calls to members, providers, and pharmacies as directed by the supervisor. Reviews and identifies opportunities for FWA (fraud, waste, and abuse) control through a review of high-cost drug claims as directed by pharmacists. All outreach activities, documents and reporting requirements are prepared and conducted in a professional and well-coordinated manner to comply with all Part D regulations and guidance. New York, NY, USPosted 5 hours ago Classroom Aide/Without Walls Day Program Assistant. Ability Beyond Assist adults w/ developmental and physical disabilities either in a classroom site based day program setting OR in an off site community based day program setting. Integrate people w/ disabilities into the community to participate in recreational, leisure, and/or volunteer activities. Role model socialization skills for people w/ disabilities Assist people w/ disabilities with daily living such as personal care as needed. Transport people w/ disabilities to and from day program and/or recreational outings. Help people w/ disabilities achieve their goals based on their preferences and abilities. Ensure proper electronic and physical documentation of daily individualized case notes Collaborate with an interdisciplinary team that includes nurses, behaviorists, & nutritionists Benefits: Extensive paid training and certification program Generous benefit package (medical, dental, vision, pet insurance) Paid time off (increases over years of service) Self-directed retirement plan options (403B) PSLF loan forgiveness eligibility NYS Healthcare Worker Bonus eligibility Flexible work schedules and overtime available that allow for work life balance Access to an Employee Assistant Program including mental health resources Ongoing diversity, equity, inclusion, & belonging initiatives Accredited certification programs in direct care, leadership, and other specialties Employee mentorship program Opportunities for growth and advancement A culture of appreciation, respect, and teamwork Qualifications: High School Diploma or Equivalent Valid Driver’s License is required Willingness to learn, no experience needed To see a day in the life our Ability Beyond workforce, check out this video: PandoLogic. Keywords: Day Program Assistant, Location: New Rochelle, NY - 10801 , PL: 592588778 New Rochelle, NY, US, 10801Posted 5 hours ago Contracting Administrator. MetroPlusHealth MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health 's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus Health has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. New York, NY, USPosted 5 hours ago Medicare Care Managment Team Lead (RN) MetroPlusHealth Under the direction of the Senior Director of Integrated Case Management or Designee, the Medicare Care Manager Team Lead manages day to day activities of the case management team (Case Managers and Case Management Associates) to ensure quality outcomes (i.e., reduction in emergency room visits and hospital admissions, improved member satisfaction) and cost effectiveness. This is accomplished through hands-on, participatory management where all aspects of day-to-day case management operations are supervised and feedback is shared with the leadership team for the purpose of meeting program goals and the implementation of continuous quality improvement strategies. The Medicare Care Manager Team Lead spends approximately 80% of the time in the field to provide on the job training, supervise visits, ongoing support and mentorship. New York, NY, USPosted 5 hours ago Social Worker (Per Diem) MJHS MJHS is a large not-for-profit health system in the Greater New York area. Our range of health services include home care, hospice and palliative care for adults and children, rehabilitation and nursing care at Menorah and Isabella Centers, and the research based MJHS Institute for Innovation and Palliative Care. We also offer Elderplan/HomeFirst: health plans for Medicare and dual-eligible individuals. As a not-for-profit organization, many of our programs and services are made possible through the generosity of grateful families, corporate donors and grants, as well as our own employees. New York, NY, USPosted 5 hours ago Evening Shift Nursing Supervisor. Discovery Behavioral Health The Evening Shift Nurse Supervisor will provide supervision over other nurses and have administrative duties. He/she consults with the physician and psychiatrist to ensure appropriate medical interventions are achieved, and carries out all orders received, with appropriate information sharing with the Program Director and Facility Manager. The Nurse Supervisor meets with each client daily, completes a daily assessment, and administers all prescription medication. Lumberton, NJ, US, 08048Posted 5 hours ago Description
Job Description 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 Delegated Vendor Account Manager will provide oversight of assigned delegated contracted vendors for all Elderplan/Homefirst Products. The oversight includes relationship management, contract implementation, analysis and monitoring in accordance with Elderplan’s operational and service goals.
High School Diploma required Bachelor Degree preferred 3 to 5 years of experience in Managed Care Organization(s), Provider Relations and knowledge of provider contracting; or at least 5-8 years of experience in Sales and/or Account Management with demonstrated knowledge of managing and cultivating relationships with new contact and existing business partnerships Knowledge of Microsoft Office, proficiency in Excel and Word is required Critical thinking, ability to absorb, retain and apply a wide range of information about the company, procedural policies and benefits Attention to detail and problem solving skills Ability to interpret a variety of instructions given in written or oral form Evaluate data, summarize and make recommendations for change Excellent oral and written communication skills Excellent time and project management skills; ability to multi-task and prioritize work while working autonomously Experience working with managed care operations with Medicaid and Medicare benefits Ability to interpret contracts for purposes of implementation and monitoring vendor performance View more..