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MLTC Operations Specialist

RiverSpring Health Plans
York, NY Full Time
POSTED ON 10/6/2025
AVAILABLE BEFORE 12/5/2025

Operations Specialist – Managed Long Term Care (MLTC) - Immediate Opportunity

Join Our Team as an Operations Specialist at RiverSpring Health Plans!

Do you have a passion for caring for older adults? If so, you've found the perfect place to advance your career! Join our compassionate and dedicated team and make a meaningful difference in the lives of our members.

RiverSpring Health Plans serves over 18,000 frail and disabled individuals, empowering them to live independently in their homes for as long as possible.

The Operations Specialist is responsible for the clerical, administrative, customer service and coordination activities to support care management and member services. Responsibilities may include ordering of services and supplies, and assuring their timely delivery; member services representative’s duties, including inbound and outbound call responsibility and other duties as needed to support care management and member services. The Operations Specialist supports the provision of care plans. S/he may order services for members (equipment and supplies, transportation, personal care, etc.), take requests for services from members, assist Nurse Care Managers with member interactions, and take authorizations from Nurse Care Managers for processing. S/he will answer incoming calls, make outgoing calls as requested and/or review member care management survey results identified issues requiring follow up.

Qualifications:

  • High School Diploma (or General Education Degree (GED) required.
  • Some college/ Business school preferred or equal experience. Medical billing or terminology experience strongly preferred.
  • Excellent verbal and written communication skills.

Compensation:

  • Hourly salary: $26.4423
  • Benefits include health insurance, retirement plans, paid time off, and professional development opportunities

If you’re ready to make a significant impact in the lives of older adults and support their wound care needs, we would love to hear from you!

Equal Opportunity Employer (EOE)

Salary : $26

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