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Posted: Thursday, February 8, 2018 2:23 AM

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 employee is responsible for the oversight of the Care Management Department s daily operations and the Interdisciplinary Care Team and provides guidance and expertise as needed. Provides ongoing department training and updates to policies, regulations and workflows to ensure high quality and continuity of member care and appropriate allocation of member services and resources for both the Medicare and Medicaid populations.+ Bachelor's degree in nursing, public administration, gerontology, social work or related health care field required. Masters preferred.+ 3-5 years of management experience in a managed care health plan.+ Working knowledge of utilization management, case management and complex care philosophies.+ Previous Medicare and Medicaid experience. CCM preferred.+ Proficiency with Word/Excel, Internet access, telephone, fax.+ NYS RN license and registration or MSW/CSW CCM preferred.+ Excellent customer service, oral communication, writing, and typing skills.+ Ability to demonstrate effective critical thinking and problem solving skills.+ Excellent telephone assessment skills.+ Working knowledge of utilization management processes.+ Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies.+ Ability to provide appropriate support and direction to facilitate collaborative efforts toward accomplishing Department goals and objectives.+ Ability to set priorities.We truly value our staff and further acknowledge their contributions by offering:+ Employee and family health coverage+ Competitive salaries+ Employer contributed pension plan+ Generous time off+ Tuition reimbursement+ 403(b) retirement planReq #: 107070Office or Field: Office-basedExternal Company Name: Metropolitan Jewish Health SystemExternal Company URL: Associated topics: ambulatory, bsn, domiciliary, hospice, intensive, intensive care, intensive care unit, psychiatric, recovery, transitional
Associated topics: domiciliary, infusion, intensive care unit, neonatal, nurse, nurse clinical, psychatric, recovery, registered nurse, surgical


• Location: Brooklyn

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