Job Ref: 102920
Category: Claims
Department: OFFICE CORPORATE COMPLIANCE
Location: 50 Water Street, 7th Floor,
New York,
NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $100,000.00
Salary Range: $100,000.00 - $115,000.00
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
Reporting to the Director of Business Process Monitoring, the Manager of Claims Business Process Monitoring is an essential part of the mandatory Compliance Program and is responsible for overseeing regularized auditing of claims processed by MetroPlusHealth. The Manager of Claims Business Process Monitoring will be tasked with ensuring that an effective system of routine auditing for identified compliance risks is maintained.
Professional Competencies
#LI-Hybrid