Labor and Employee Relations Business Partner Job Ref 106221 Category Human Resources Department HR OPERATIONS Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $95,000.00 Salary Range $95,000.00 $105,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities thro

Case Management Associate (High Risk OB, Social Determinants of Health) Job Ref 102738 Category Professional Department CASE MANAGEMENT PROGRAM Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $50,000.00 Salary Range $50,000.00 $50,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yor

The Assessment Nurse is the first person that the potential member/member and family meet from the MLTCP programs. The Assessment Nurse conducts the UAS assessment to determine the level of care needed to support applicants/members in their own homes. The Assessment Nurse completes the UAS assessment tool and makes the determination if an applicant is appropriate for the

The Claims Service Correspondent is responsible for accurate and timely response to written claim inquiries received from providers. This individual provides support regarding the adjudication and adjustment of claims for multiple lines of business. They will work closely with Provider Contracting, Medical Management, Enrollment and Membership department, and Claims Proce

MetroPlus Health is seeking a Business Transformation Lead who will help drive the way we conduct and operate traditional business functions, challenging the status quo and injecting innovative thought leadership to improve operational efficiencies and lead the flawless execution. The Business Transformation Lead will partner with our cross function stakeholders to introd

The Care Management Associate, under the direction of the CMA Supervisor, is responsible for the daily activities of the member case intake functions and associated workflow, as well as for performing other duties associated with the coordination of member care as outlined for the MLTC/PCS Team. Job Description Handles both incoming and outgoing calls on the MLTC/PCS ACD

The primary goal of the Transitions of Care (TOC) Care Manager is to provide care coordination services as members move from one setting to another. Examples of these settings include inpatient facilities, emergency department, rehabilitation facilities, long term care facilities, and certified home health agencies. The goal is to prevent re admissions and reduce avoidabl

Sales Representative I Staten Island Job Ref 97058 Category Sales Department FACILITATED ENROLLMENT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $50,000.00 Salary Range $50,000.00 $50,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We

Sales Representative I Queens (Bilingual Haitian Creole) Job Ref 71393 Category Sales Department FACILITATED ENROLLMENT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $50,000.00 Salary Range $50,000.00 $50,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communit

Quality Management Health Navigator Job Ref 106120 Category Member Services Department QUALITY MANAGEMENT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $50,000.00 Salary Range $50,000.00 $60,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through ca

Sales Representative I Brooklyn (Bilingual Spanish) Job Ref 104596 Category Sales Department FACILITATED ENROLLMENT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $50,000.00 Salary Range $50,000.00 $50,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities

MetroPlus Health seeks an Instructional Designer who has a passion for creating engaging, innovative, and effective learning solutions. The individual in this role will provide leadership and support for the development of the learning curriculum via different mediums. These mediums may include, but are not limited to, e learning, in class learning, presentations, etc. Jo

Product Implementation Specialist Job Ref 103924 Category Professional Department MHP PRODUCT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $75,000.00 Salary Range $75,000.00 $85,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We belie

Responsible for providing provider onboarding, training for claims and billing procedures, contract compliance, Product, medical management, and pharmacy issues. Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities, inclusive of behavioral health network. Job Description Provide provider onboarding alo

The Payment Integrity (PI) Analyst will assist in the development of a strategic roadmap to recover, eliminate, and prevent unnecessary medical expense spending and support the execution for a comprehensive claim accuracy program. The incumbent will optimize pre/post claim editing, auditing, and claim recovery programs that will drive incremental value year over year. The