Overview Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Ensures regulatory compliance, timeliness requirements and accuracy standards are met. Coordinates efficient functioning of day to day operations according to defined processes and proc

Overview Supervises Home Health Aides delivering service to clients in the home care setting and coordinates all related administrative responsibilities. Works under general supervision. Compensation $20.98 $26.23 Hourly What We Offer Referral bonus opportunities Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays Health insurance pla

Overview Leads the development, analysis and reporting of key risk adjustment metrics, as well as oversees analyses of new legislation and regulations regarding Risk Adjustment and assessing the impact of any changes to the programs. Maximizes revenue strategies for VNS Health Plans. Coordinates multiple cross functional activities and projects related to risk adjustment

Overview Leads a Care Management team focusing on managed Medicare and Medicaid for a national health plan. Overseas administrative and clinical duties within the Care Management Program for clinically complex patients with chronic conditions, ensuring effective staff utilization for maintaining high quality patient care aligned with program goals and mission. Supports th

Overview Completes data input for authorization/service requests. Works collaboratively with other departments to troubleshoot and resolve authorization related issues in a timely and efficient manner. Ensures timely and effective delivery of services. Works under general supervision. Compensation $20.98 $26.23 Hourly What We Provide Referral bonus opportunities Generous

Overview Supervises the day to day operations and coordinates all work activities of the non clinical authorization team. Ensures a customer focused operation that meets organizational standards, goals, and objectives. Makes recommendations on operational improvements for the department. Works under general direction. Compensation $62,400.00 $72,000.00 Annual What We Prov

Overview Behavioral Health Counselors provide supportive counseling, advocacy, and education to help patients and their families navigate mental illness, access community resources, and manage symptoms to help them remain safely in the community This is an experienced, master's level social services role that provides direct care as part of a team. Join us in building on

Overview Are you passionate about making a positive impact on people's lives? Do you thrive in a collaborative environment where you can be part of an interdisciplinary team dedicated to restoring the health and well being of clients? Look no further VNS Health Personal Care is seeking compassionate and skilled Certified Home Health Aides like you! Please join us for one

Overview Plans and implements population/disease management programs and related protocols/policies based on evaluation of clinical outcomes and staff practice patterns. Collaborates with staff to improve clinical outcomes. Provides expert consultations, staff development plans, and continuous quality improvement (CQI) strategies. Works under general supervision. Compensa

Overview Plans, manages, and evaluates clinical orientation and ongoing education and training programs for staff for one or more programs across VNS Health. Collaborates with regional/program leadership in the delivery of new hire and ongoing clinical education and competency development. Develops new and modifies existing curriculum and training materials to ensure all

Overview Conducts daily reviews of case files, letters, and database records against required criteria. Ensures compliance with VNS Home care policies and procedures, regulatory requirements and business practices up to an including contractual arrangements with payers. Prepares summary reports and provides recommendations to reduce errors and improve process performance.

Overview VNS Health Home Care RNs redefine the standard of patient centered care for New Yorkers while keeping them out of the crowded hospital system so they can heal and age where they are most comfortable in their homes and community. Our nurses provide the Future of Care by meeting patients where they are. We design and deliver individualized care plans and exceptiona

Overview Are you passionate about making a positive impact on people's lives? Do you thrive in a collaborative environment where you can be part of an interdisciplinary team dedicated to restoring the health and well being of clients? Look no further VNS Health Personal Care is seeking compassionate and skilled Certified Home Health Aides like you! Please join us for one

Overview Prepares and distributes member communications materials for VNS Health Health Plans in accordance with federal, state and business requirements. Ensures all materials produced and submitted to CMS and/or the State Department of Health reflect relevant regulations. Uses consumer communications best practices to develop communications programs and materials that s

Overview Are you passionate about making a positive impact on people's lives? Do you thrive in a collaborative environment where you can be part of an interdisciplinary team dedicated to restoring the health and well being of clients? Look no further VNS Health Personal Care is seeking compassionate and skilled Certified Home Health Aides like you! Please join us for one