Welcome page Returning Candidate? Log back in! Job Locations US-NY-New York Req # 2619 Agency Elderplan Status Per Diem Location : Postal Code 10041 Category Managed Care Nursing Office or Field Office-based Overview

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?

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

Responsibilities

Responsible for quality management clinical review activities including but not limited to medical record reviews for the annual HEDIS project and quality of care issues. Works collaboratively with Provider Relations, Business Development, and external vendors to ensure compliance with medical record and incentive requirements.

Qualifications RN required. Bachelors degree in healthcare, business, finance, or other related analytical fieldsMinimum 3-5 years’ experience in the healthcare or managed care industry, or related fieldExperience and knowledge with HEDIS, CAHPS, CMS Star Ratings, and Accreditation process

Experience with project management skills, planning, and budgeting

Ability to work in a fast-paced and dynamic environment with minimal supervision and direction and to constantly redefine responsibilities to meet business needs

Acts with a sense of urgency

Computer literacy and experience with word processing, spreadsheets, database programs and good typing skills

Knowledge, understanding, and accurate interpretation of product line related specifications, methodologies, and processes

Excellent interpersonal skills to manage, motivate, and influence departmental staff in successfully accomplishing of their duties

Ability to demonstrate effective critical thinking and problem solving skills Min USD $55.00/Yr. Options Apply for this job onlineApplyShareRefer this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Application FAQs

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