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:
Sign-on Bonuses OR Student Loan Assistance for clinical staffFREE Online RN to BSN and MSN degree programs!Tuition Reimbursement for all full and part-time staffDependent Tuition Reimbursement for clinical staff!Generous paid time offAffordable medical, dental and vision coverage for employee and family membersTwo retirement plans! 403(b) AND Employer Paid PensionFlexible spendingAnd MORE!
MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)
ResponsibilitiesResponsible for managing day-to-day activities of the Member Operations staff. Analyzes existing procedures and develops workflows and processes based on analysis and regulatory changes, and communicates these changes to staff. Manages the internal audit processes and recommends appropriate action. Generates, maintains and distributes member eligibility files to vendors by the secure means and according to the distribution schedule specified by the vendor. Prepares for, and participates in, external regulatory audits (e.g. DOH, DOI, and CMS). Assist the Director with the production of the monthly board reports.
Qualifications Bachelor's degree required, Master's degree preferredTwo years experience in a supervisory role preferredProficiency in MS office (Access, Excel, PowerPoint, Word) required; experience with AMISYS, Market Prominence, Crystal Reports preferredKnowledge of managed care organizations, CMS and Federal regulationsAbility to multitask, think and act independently, delegate appropriatelyDetailed oriented and analytical Min USD $54,878.02/Yr. Max USD $65,853.63/Yr. Options Apply for this job onlineApplyShareRefer this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Application FAQsSoftware Powered by iCIMS
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