Quality Review & Staff Education Supervisor

Req #:

4017

Job ID:

15420

Job Location:

New York, NY

Zip Code:

10041

Category:

Management - Clinical

Agency:

Elderplan

Status:

Regular Full-Time

Office:

Office-based

Salary:

$109,624.15 - $137,030.19 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.

The MJHS Difference

At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.

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, including your birthday!
• Affordable and comprehensive 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:

Care Management Supervisor of Quality Review & Staff Education is responsible for quality assurance, accuracy, and overall integrity of the care management records completed by Care Management staff. This role is to ensure compliance with NYS DOH and CMS regulations through development of auditing tools and data validation. This Supervisor is responsible to analyze collected audit data, identify trend for staff re-training, and implementing corrective action plans in collaboration with Clinical Management and Staff Education. Oversees and conducts orientation, training and education to all members of Care Management team. Provides support to Director and Managers of Coordinated Care to ensure that all reporting requirements are prepared, submitted, and maintained in a professional and well-coordinated manner. 

Qualifications:

• Baccalaureate Nursing Degree from an NLN-Accredited School of Nursing
• Experience and knowledge of Managed Care: A minimum of two years nursing experience in Community Health or related field and/or minimum of two years of progressive job-related experience, including care management and coordination, education and supervision
• Demonstrates strong critical-thinking, problem-solving skills and knowledge of Medicare and Medicaid
• Effective communication skills, both written and oral
• Possess strong critical thinking skills and knowledge of Medicare and Medicaid regulations
• Excellent analytical skill, interpretation of data
• Ability to set priorities and to handle multiple assignments
• Working knowledge of audit techniques and methodologies
• Secures relevant information to identify potential problems and makes recommendations for appropriate solutions
• Work effectively within interdisciplinary team environment
• Computer literate, Windows, Excel, Word, Visio and data base programs required. PowerPoint preferred
• Working knowledge of State and Federal regulations

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