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About the Role
Elderplan and HomeFirst are Medicare and Medicaid managed care health plans that provide high-quality healthcare designed to help people live independently. Employees in non-clinical roles can make a positive impact on the lives of health plan members.
Responsibilities
- Processes all requests for services in accordance with Medicare and NYS Medicaid Guidelines as well as departmental criteria and guidelines.
- Works collaboratively with other disciplines including Care Manager, Assessment Nurse and Primary Care Physician or other Specialists as necessary to ensure timely provision of services.
- Coordinates timely completion of UAS NY assessment that accurately reflects current condition of the member.
- Ensures that the member’s Individualized Person-Centered Care Plan has been updated and accurately reflects present status of the member.
Requirements
- Graduate of an accredited nursing program, Bachelor’s preferred
- Knowledge with Utilization management processes preferred
- Current NY RN license and registration required
- CCM preferred
- Minimum three to five years nursing experience in long term care, managed care, home care, geriatrics or hospice
- Prior experience in an interdisciplinary service delivery environment preferred
- Working knowledge of Medicare and Medicaid regulations
- Working knowledge of Windows, Word and Excel
- Knowledge of current standards of medical practice and healthcare delivery systems
- Strong assessment skills
- Knowledge of Interqual preferred
Skills
- Assessment skills
- Windows
- Word
- Excel
Location
- NY
Work Type
- Full-time
Experience Level
- 3-5 years
Education Level
- Bachelor's preferred
- Graduate of an accredited nursing program
Salary/Compensations
- $90,000.00 - $110,000.00
Benefits
- Sign-on Bonuses OR Student Loan Assistance for clinical staff
- Free MSN in Education program!
- 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
About the Company
- 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.
- MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)