Medicare Regulatory Compliance Specialist Job Ref 106703 Category Professional Department OFFICE CORPORATE COMPLIANCE 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 $88,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communitie

The Regulatory Compliance Specialist reports to the Director of Regulatory Compliance. The Specialist will support the oversight and management of Medicaid regulatory compliance activities, including monitoring of all related regulatory guidance for compliance work plan activities, supporting the organization with corrective actions and regulatory disclosures, contributin

EDI Software Developer (BizTalk) Job Ref 103418 Category Information Technology Department INFORMATION TECHNOLOGY Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $120,000.00 Salary Range $120,000.00 $120,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities

Senior Account Manager, Provider Engagement Job Ref 105307 Category Professional Department Provider Network Operations Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $90,000.00 Salary Range $90,000.00 $101,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communi

Senior Account Manager, Provider Engagement Job Ref 105314 Category Professional Department Provider Network Operations Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $91,000.00 Salary Range $91,000.00 $101,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communi

The Behavioral Health UM Care Coordinator provides comprehensive service and support to providers and members as needed. The primary responsibilities include but are not limited to responding to all provider inquiries for Behavioral Health Core and HARP authorizations, documenting such contacts into the tracking clinical system, manage and maintain inbound queues for the

Under the supervision of the Director of Long Term Care Clinical Programs, the MLTC Care Manager Team Lead is responsible for the day to day supervision of a team of care managers within the MLTC department as they strive to keep our members safe and thriving at home. The Care Manager (CM) Team Lead provides comprehensive support and guidance on processes/workflows, ident

Under the direction of the Assessment Nurse Team Lead, and in collaboration with the member's Care Manager, this role will conduct an in person home visit for MLTC and MAP members at a 6 month interval from the member's UAS. The home visit includes a brief health assessment on medical and behavioral health topics as well as a quick environmental scan of the member's home.

Identify prospective enrollees and determine eligibility for participation in MetroPlusHealth's Medicare product. Understand and apply all policies and procedure pertaining to Disclosures and provisions of the MetroPlusHealth Medicare product. Enrollment and disenrollment. Conduct home visits, and personalized appointments as needed to complete the enrollment process. Mar

Reporting to the Vice President of Provider Network Operations, the Director of Provider Engagement will lead the Provider Engagement team and have overall accountability to develop and maximize improved alignment, driving high performance and provide world class engagement experience with identified key providers. By leading market level projects and strategies for provi

Director of Provider Data Integrity and Program Management Job Ref 105326 Category Professional Department Provider Network Operations Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $145,000.00 Salary Range $145,000.00 $155,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers b

Collaborate with the internal and external teams to develop and maintain the MLTC/MAP disenrollment operational processes and procedures. Coordinate the MLTC/MAP enrollment and disenrollment workflow. Troubleshoot cases which require further investigation by Marketing or Maximus to complete the eligibility and enrollment process Provide feedback regarding eligibility or e

Manager of Call Center Quality and Compliance Job Ref 104050 Category Call Center Department CALL CENTER 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 car

Material/Supply Administration and Outreach/Promotional Support To deliver and distribute marketing materials, supplies and equipment as needed to Sales Representatives, Customer Success Specialists, Supervisors, and Managers at various sites. Load and unload supplies at point of pick up, delivery, and distribution. Assist Sales Representatives, Customer Success Specialis

Collaborates with IT Security management in the development of enterprise Security assessment tools and policy and procedures. Assesses information risk and facilitates remediation of identified vulnerabilities with the organization, systems and applications and vendors. Reports on findings and recommendations for corrective action. Job Description Collaborates with IT Se