Member Operations Supervisor

Req #:

2745

Job ID:

14248

Job Location:

New York, NY

Zip Code:

10041

Category:

Management - Non-Clinical

Agency:

Elderplan

Status:

Regular Full-Time

Office:

Office-based

Salary:

$54,878.02 - $65,853.63 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:

• Sign-on Bonuses OR Student Loan Assistance for clinical staff
• FREE Online RN to BSN and MSN degree programs!
• Tuition Reimbursement for all full and part-time staff
• Dependent Tuition Reimbursement for clinical 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:

Responsible for managing day-to-day activities of the Member Operations staff. Analyzes existing procedures and develops workflows and processes based on analysis and regulatory changes, and communicates these changes to staff. Manages the internal audit processes and recommends appropriate action. Generates, maintains and distributes member eligibility files to vendors by the secure means and according to the distribution schedule specified by the vendor. Prepares for, and participates in, external regulatory audits (e.g. DOH, DOI, and CMS). Assist the Director with the production of the monthly board reports.

Qualifications:

• Bachelor's degree required, Master's degree preferred
• Two years experience in a supervisory role preferred
• Proficiency in MS office (Access, Excel, PowerPoint, Word) required; experience with AMISYS, Market Prominence, Crystal Reports preferred
• Knowledge of managed care organizations, CMS and Federal regulations
• Ability to multitask, think and act independently, delegate appropriately
• Detailed oriented and analytical

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