Find Jobs Showing 31–40 of 13,162 jobs
Manager of Coordinated Care 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 employee is responsible for the oversight of the Care Management Department’s daily operations and the Interdisciplinary Care Team and provides guidance and expertise as needed. Provides ongoing department training and updates to policies, regulations and workflows to ensure high quality and continuity of member care and appropriate allocation of member services and resources for both the Medicare and Medicaid populations.
Bachelor's degree in nursing, public administration, gerontology, social work or related health care field required. Masters preferred. 3-5 years of management experience in a health care setting. Previous managed care experience preferred. Working knowledge of utilization management, case management and complex care philosophies. Previous Medicare and Medicaid experience. CCM preferred. Proficiency with Word/Excel, Internet access, telephone, fax. NYS RN license and registration or MSW/CSW CCM preferred. Excellent customer service, oral communication, writing, and typing skills. Ability to demonstrate effective critical thinking and problem solving skills. Excellent telephone assessment skills. Working knowledge of utilization management processes. Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies. Ability to provide appropriate support and direction to facilitate collaborative efforts toward accomplishing Department goals and objectives. Ability to set priorities. Posted 8 hours ago Delegated Vendor Account Manager. MJHS 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. Posted 8 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. Posted 8 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. Posted 8 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. Posted 8 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 Posted 8 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. Posted 8 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. Posted 8 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. Posted 8 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. Posted 8 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 employee is responsible for the oversight of the Care Management Department’s daily operations and the Interdisciplinary Care Team and provides guidance and expertise as needed. Provides ongoing department training and updates to policies, regulations and workflows to ensure high quality and continuity of member care and appropriate allocation of member services and resources for both the Medicare and Medicaid populations.
Bachelor's degree in nursing, public administration, gerontology, social work or related health care field required. Masters preferred. 3-5 years of management experience in a health care setting. Previous managed care experience preferred. Working knowledge of utilization management, case management and complex care philosophies. Previous Medicare and Medicaid experience. CCM preferred. Proficiency with Word/Excel, Internet access, telephone, fax. NYS RN license and registration or MSW/CSW CCM preferred. Excellent customer service, oral communication, writing, and typing skills. Ability to demonstrate effective critical thinking and problem solving skills. Excellent telephone assessment skills. Working knowledge of utilization management processes. Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies. Ability to provide appropriate support and direction to facilitate collaborative efforts toward accomplishing Department goals and objectives. Ability to set priorities. View more.. 
