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A&G Fair Hearing RN Coordinator

Req #: 107593
Job Location(s): Brooklyn, NY
Zip Code: 11220
Category: Managed Care Nursing
Agency: Elderplan
Status: Regular Full-Time
Office: Office-based

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!

Responsibilities:

As a representative for Elderplan/Homefirst Appeals & Grievance Department, collaborates with Case Management Department and Appeals Coordinators for the preparation of fair hearing case files and presentation of fair hearings in-person and/or telephonic. Appears at scheduled in-person NYS Fair Hearings and attend telephonic fair hearings as needed.

Qualifications:

  • Graduate of accredited nursing program
  • BSN or equivalent experience required
  • Registered Professional Nurse NYS License
  • Minimum of three years Managed Care experience in UM or CM
  • Minimum of two years Appeals & Grievance experience
  • Minimum two years clinical experience in acute care, SNF and/or home care

Connect With Us!:

Not ready to apply? Connect with us to learn about upcoming opportunities and events at MJHS.

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