Metropolitan Jewish Health System, Inc.
New York / Global
Care Management Coordinator
- $45.000 - $60.000
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New York / Global
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.
Responsibilities
Processes all newly enrolled cases according to established EP/HF Coordinated Care team workflows and maintains integrity of members’ files
Receives and processes requests and inquiries through interdepartmental communication system regarding covered/ non covered services/supplies
Receives and processes initial requests and inquiries regarding pre-authorization of services/supplies.
Coordinates and provides service authorizations to vendors
Accurate and timely data entry support as defined by departmental workflows
Participates in scheduled team meetings
Qualifications
High School Diploma or equivalent; college degree preferred.
One year prior managed care experience required.
Prior experience in a health care setting preferred.
Familiarity with utilization management/case management.
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