RN Care Coordinator (Managed Care - Telephonic)

Employer
Location
Elderplan, Brooklyn, NY
Salary
Competitive
Posted
9/4/2017
Closes
9/29/2017
Specialty
Support Staffing
Contract Type
Permanent
Hours
Full Time
 
MJHS Header
 
  We believe that nurses give their best care when they know they are being cared for too. When you work for MJHS, you’ll be valued and respected for your dedication to world-class patient care. You’ll be encouraged and challenged to learn and grow. Most of all, you’ll be rewarded with work/life programs that help you balance your priorities and enjoy the career you’ve always wanted. You won’t find that everywhere. But you will find it here.  
 
  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.  Even in a non-clinical role, employees have an opportunity to make a positive impact on the quality of our health plan members' lives.

Responsibilities:
Process 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.

Qualifications:
  • 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
  • Prior experience in an interdisciplinary service delivery environment preferred
  • 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

Benefits:
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
  • Employee tuition reimbursement
  • Dependent tuition reimbursement
  • 403(b) retirement plan

 
 

We are an equal opportunity employer M/F/D/V.

www.mjhs.jobs