Utilization Management Support Supervisor

Req #:

2648

Job ID:

14171

Job Location:

New York, NY

Zip Code:

10041

Category:

Management - Non-Clinical

Agency:

Elderplan

Status:

Regular Full-Time

Office:

Hybid

Salary:

$61,463.13 - $73,755.75 per year

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.

Why work for MJHS?:

When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No?  You will here!  You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals.  You take care of our patients, residents and health plan members, and we will take care of the rest!

 

 

Benefits include:

Tuition Reimbursement for all full and part-time staff
Generous paid time off
Affordable medical, dental and vision coverage for employee and family members
Two retirement plans! 403(b) AND Employer Paid Pension
Flexible spending
And MORE!

 

MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Responsibilities:

Provides daily oversight of the Utilization Management Support Services unit. Responsibilities include, but are not
limited to staffing, call monitoring, quality assurance/process monitoring, customer problem resolution, enrollment, and
provider relations. Works with the management team of Coordinated Care in creation and implementation of shared
projects and workflows to ensure compliance with NYS DOH and CMS regulations. Responsible for oversight of service
authorizations and admission/discharge documentation processing. Assists staff in managing caseloads and provides
ongoing monitoring of staff productivity, attendance, and quality of work.

Qualifications:

• Baccalaureate Degree preferred, 3 to 4 years’ experience in healthcare
• 4-5 years’ experience in business, human services, or a health-related field
• 2 years supervisory experience preferred.
• 2-3 years’ experience in provider relations and/or member services in managed
  care.
• Prior experience with Medicaid managed care.
• Knowledge of the service delivery needs of the elderly, chronically ill or
  disabled.
• Working knowledge of Windows, Word, Excel and care management/utilization
  management software systems
• Strong interpersonal and organizational skills
•  Excellent written and verbal communication skills
• Excellent analytic skills, interpretation of data
• Possess strong critical thinking skills and knowledge of Medicare and Medicaid
  regulations.
• Work effectively within interdisciplinary team environment
  Ability to set priorities and to handle multiple assignments.
• Working knowledge of audit techniques and methodologies
• Working knowledge of State and Federal regulations
• Possess good judgment and sense of urgency
•  Ability to secure relevant information to identify potential problems, escalate, and
  make recommendations for appropriate solutions

Apply