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?

When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No? You will here! You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals. You take care of our patients, residents, and health plan members, and we will take care of the rest!

Benefits include:

• Tuition Reimbursement for all full and part-time staff
• Generous paid time off
• Affordable medical, dental and vision coverage for employee and family members
• Two retirement plans! 403(b) AND Employer Paid Pension
• Flexible spending
• And MORE!

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

Responsibilities

Provides oversight of Community Health Coach unit daily operations. Responsibilities include, but are not limited to staffing of the unit, scheduling and visit completion oversight, call monitoring, quality assurance/process monitoring and customer problem resolution. Assists management of Coordinated Care in creation and implementation of all projects, policies, and workflows to ensure full compliance with NYS DOH and CMS regulations. Responsible for outcomes of all completed visits, all required follow ups/interventions, and appropriate documentation. Ongoing monitoring of staff punctuality, attendance, and quality of work.

Qualifications

• Baccalaureate Degree in Social Work, Psychology, or other health-related field.
• 3-4 years’ experience in healthcare.
• 4-5 years’ experience in business, human services, or a health-related field.
• 2 years supervisory experience preferred.
• 2-3 years’ experience in provider relations and/or member services in managed care.
• Prior experience with Medicaid managed care.
• Knowledge of the service delivery needs of the elderly, chronically ill or disabled.
• Working knowledge of Windows, Word, Excel, and care management/utilization management software systems.
• Strong interpersonal and organizational skills.
• Excellent written and verbal communication skills.
• Excellent analytic skills, interpretation of data.
• Possess strong critical thinking skills and knowledge of Medicare and Medicaid regulations.
• Work effectively within an interdisciplinary team environment.
• Ability to set priorities and to handle multiple assignments.
• Working knowledge of audit techniques and methodologies.
• Working knowledge of State and Federal regulations.
• Possess good judgment and sense of urgency.
• Ability to secure relevant information to identify potential problems, escalate, and make recommendations for appropriate solutions.

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