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<title>MJHS Other Jobs </title>
<link>http://mjhs.jobs/</link>
<description>MJHS RSS Jobs </description>
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<title>CLAIMS PROJECT COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8205]]></link>
<description><![CDATA[Coordinates and facilitates projects for Elderplan in an effort to resolve high priority provider issues. Projects, which can involve claims, authorization, pricing, or benefit issues, are assigned by Management and final results become part of the provider file.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>HOSPICE CARE PLANNER PER DIEM</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=6907]]></link>
<description><![CDATA[Working on-site at a major medical center, the Hospice Care Planner is responsible for evaluating and establishing a plan of care for referred patients at the end stage of life. The Hospice Care Planner will facilitate admission of referrals upon discharge from the hospital to a home care program that meets the needs of the patient and family members. As a key member of the business development and marketing team the Hospice Care Planner develops and maintains positive relationships with physicians, social workers, case managers and discharge planners within the medical center.

home care, nursing, RN, homecare, nurse, home care nurse, home care RN]]></description>
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<title>PASTORAL CARE COORDINATOR PER DIEM</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8395]]></link>
<description><![CDATA[Overall responsibility for coordination of pastoral support services to patients and families. Provides direct pastoral services to patients and families. Coordinates spiritual support with requested religious affiliations for patients and families. Completes and prepares documentation from clinical contacts and patients. Inputs clinical data into MISYS database. Maintains updated intake reports.]]></description>
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<title>CUSTOMER SERVICE TRAINER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8117]]></link>
<description><![CDATA[The Trainer is primarily responsible for evaluation, design and implementation of new Customer Service employee training and staff development. The position will conduct the new hire training for all Customer Service staff, including, provider representatives, member representative and all external vendors assisting with overflow and after hour calls. The trainer will also conduct updates to all areas as needed to remain current and compliant.

The position will develop quality standards and performance matrix to monitor the staff’s effectiveness and opportunities in service delivery. The Trainer will work closely with the departments Auditors and Supervisors to develop ongoing training of Customer Service Representatives to ensure proper service delivery to Elderplan Members and Providers, as defined by the Director of Member Services and the Director of Provider Services. The position must also insure the Customer Service Staff is in compliance with governmental regulations.

The Trainer must demonstrate extensive knowledge of the Elderplan products and processes as well as compliance regulations so as to effectively perform monitoring and reporting duties that support the goals of the Customer Service Department. The Trainer must keep him/her self up to date on all regulatory changes and create appropriate Job Aides to assure compliance.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>SR PROGRAMMER ANALYST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8368]]></link>
<description><![CDATA[Defines, develops, tests, analyzes, and maintains software applications in support of the achievement of business requirements for Administrative Information Services. Researches, designs, documents, and modifies software specifications throughout the production life cycle. Works with network administrators, systems analysts, and software engineers to resolve problems with software products or internal systems and applications. Writes, translates, and codes software programs, scripts, and applications according to specifications. Designs and executes software performance tests; analyzes results and delivers solutions for problem areas. Directs work assignments and acts as a resource for junior level staff (Programmer Analysts and Business Analysts).Helps to manage interdisciplinary team during implementation and/or development projects. Makes sure tasks are completed by deadlines. Monitors costs of project to ensure they fall within budget.
We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>BENEFITS ADVISOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8439]]></link>
<description><![CDATA[Presents the Elderplan Benefit Package to 65+ population in order to enroll eligible participants into the plan in accordance to Elderplan and MJHS strategic goals. Presents Elderplan Benefits package to prospects in their home and at other locations in the community. Enrolls members in accordance with Elderplan, Medicare + Choice, Medicaid, New York State and AAHP Guidelines.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>PROVIDER CONTRACTING ASSISTANT</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7846]]></link>
<description><![CDATA[Elderplan, Inc. provides expanded Medicare health care coverage to seniors in all five boroughs for more than 20 years. Advance your career with us and enjoy outstanding stability, growth potential and a world of options.

Responsible for provider contract file maintenance and provides internal support for contracting initiatives. Tracks and maintains provider information as it pertains to general recruitment activities. Tracks provider information as it pertains to physician recruitment initiatives. Performs administrative duties supporting the contracting team.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>PROVIDER DATA COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8228]]></link>
<description><![CDATA[Performs verifications of the accuracy and validity of information currently maintained in all provider databases: Amisys, AREV/Credentialer, Access/Directory Expert. Assists in monitoring the flow of information regarding providers among functional areas within the department, as well as the organization. Assist in provider capitation payment processing and management functions. Perform provider file configuration testing and provider data integrity audits as required.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>INFORMATION SECURITY MANAGER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8407]]></link>
<description><![CDATA[We are seeking a seasoned and motivated security professional who leads the development and implementation of security policy and procedures, security risk analysis, response procedures and documented security controls. He/she will represent the security needs of the organization by providing expertise and assistance in all IT projects with regard to security, manage day-to-day security administration procedures, plan, design, and implement security policy, procedures, and standards to establish security of the company's information systems and data, coordinate security administration and issue resolution across the organization, keep management appropriately informed of all pertinent security matters and issues, lead and facilitate all activities that the Information Security program delivers in support of the business units and is responsible for the implementation of Information Security Policies, procedures, standards, technical safeguards, and solutions identified to mitigate or reduce business exposure to information security risks, communicate security-related concepts to a broad range of technical and non-technical staff and represent IT security function in audits.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Employee tuition reimbursement
 Dependent tuition reimbursement
 403(b) retirement plan]]></description>
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<title>PROVIDER SERVICES REP</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8413]]></link>
<description><![CDATA[The individual within this role acts as a liaison between Elderplan and contracted providers to promote positive relationships with the Plan and enhance services to Plan members. He/She receives, assists and resolves all provider related complaints and appeals/grievances; responds to all provider inquiries via phone, fax, e-mail or regular mail; educates providers regarding benefits, policies and procedures including plan changes and updates; assists external departments with provider issues, claims, appeals and grievances; collaborates with Customer Service department regarding phone logs and providers issues; gathers changes in provider information or status (i.e. terminations; office hours; address changes; changes in after hours; holiday and vacation coverage, etc; and performs other tasks, as deemed necessary.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>ENROLLMENT REPRESENTATIVE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8171]]></link>
<description><![CDATA[Presents the HomeFirst Managed Long Term Care Plan (MLTCP) to eligible referral sources in order to generate referrals for eligible participants into the plans, in accordance with HomeFirst Marketing Plan and Department of Health contract guidelines.
We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>ASSISTANT DIRECTOR OF HR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8050]]></link>
<description><![CDATA[Acts as a strategic partner administering Human Resources programs and policies that support the business units’ goals and objectives. Consults on a variety of HR issues with emphasis on employee relations, recruitment/retention and performance management in order to assist clients in meeting their operational objectives.  Plans and executes a comprehensive recruitment strategy utilizing a variety of tactics such as special events, print and digital advertising media and social networking to attract passive and active candidates. Works with managers and staff to increase retention, enhance employee satisfaction and improve performance through implementing on-boarding and recognition programs, individualized coaching and delivery of formal skills training.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>DATA ENTRY CLERK</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8389]]></link>
<description><![CDATA[Responsible for entering claims data from source document . Compares data entered with source documents and resolve system edits concerning invalid data by deleting incorrectly entered data, re-enter correct data. Make copies of required documents. Files documents when applicable. Maintains a production sheet of work completed on a daily basis.
We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>NETWORK SPECIALIST II</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8107]]></link>
<description><![CDATA[Performs analysis of local area network (LAN) and wide area network (WAN) needs and contributes to the design and maintenance of data network architecture, integration, and installation. Installs and configures local area network hardware and software, including servers, switches, routers, peripherals, terminals, and wiring. Monitors availability and utilization of servers, switches, and UPS by using various tools. Troubleshoots advanced networking and e-mail problems. Troubleshoots basic routing problems. Prepares and maintains documentation of network configuration and cabling layouts. Evaluates network and application requirements and makes hardware recommendations. Provides technical support to application and desktop support teams. Schedules and performs server backups.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>KITCHEN PORTER PART-TIME</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8032]]></link>
<description><![CDATA[Under the supervision of the Director, Nutritional Services, is responsible for cleaning and storing all items used for food preparation and service. Additional responsibilities include maintaining the cleanliness of the kitchen.
This is an 1199 represented position that offers an excellent compensation and benefits package.]]></description>
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<title>HOSPICE CARE PLANNER PER DIEM</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=6909]]></link>
<description><![CDATA[Working on-site at a major medical center, the Hospice Care Planner is responsible for evaluating and establishing a plan of care for referred patients at the end stage of life. The Hospice Care Planner will facilitate admission of referrals upon discharge from the hospital to a home care program that meets the needs of the patient and family members. As a key member of the business development and marketing team the Hospice Care Planner develops and maintains positive relationships with physicians, social workers, case managers and discharge planners within the medical center.

home care, nursing, RN, homecare, nurse, home care nurse, home care RN]]></description>
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<title>SENIOR BENEFITS ADVISOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7991]]></link>
<description><![CDATA[Presents the Elderplan Benefit Package to 65+ population in order to enroll eligible participants into the plan in accordance with Elderplan and MJHS strategic goals. Enroll members in accordance with Elderplan, CMS and New York State guidelines. Develop territory by creating and maintaining community relationships. Meet all stated departmental goals. Prepare necessary paperwork including enrollment forms, expense reports, daily activity reports and weekly activity sheets.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>PROVIDER SERVICES MANAGER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8436]]></link>
<description><![CDATA[The Provider Service Manager will provide day to day provider relations and contracting to the Upstate NY Region. The manager will be responsible developing and maintaining positive provider relations to ensure provider satisfaction. Other duties include: provider recruitment, analyzing, troubleshooting and researching provider questions and escalations, using knowledge of CMS regulations.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>PROVIDER ACCOUNT LIAISON</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8217]]></link>
<description><![CDATA[The Provider Account Liaison develops and maintains strong relationships with strategically important IPAs. The Provider Account Liaison coordinates with appropriate cross functional resources to ensure successful execution of the provider contract and the achievement of provider membership growth and financial results.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>EVENTS COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8313]]></link>
<description><![CDATA[The MJHS Foundation seeks to hire an Events Coordinator who will support the execution of a multi-faceted development plan by assisting with planning, managing and executing MJHS Foundation-sponsored cultivation and fundraising events.  This includes oversight of event logistics, establishing and maintaining vendor relationships, coordinating other MJHS department involvement, and reporting on event results.  The Coordinator works closely with the Director of Development and the entire Foundation Team, as well as committees of employees, volunteers and other lay leaders to support an event.  The Coordinator assists with fundraising activities including the MJHS Golf Classic, Hospice on Broadway, events associated with the Employee Giving Campaign, and events for the Sixteen Lights Capital Campaign. The position provides support for mailings, acknowledgments, recognition, and tracking in the Raiser’s Edge donor database. The Coordinator also assists with messaging and communications strategies, including marketing, public relations and social media related to development and fundraising efforts. The role will require close attention to detail, ability to multitask, and excellent interpersonal skills.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>HEALTH ASSESSMENT COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7967]]></link>
<description><![CDATA[Welcomes all new enrolled members into the plan and expedites the identification, assessment, classification and referral process. The Health Assessment Coordinator provides a telephonic pre-screening to assess members social, psychological, and physical impairments. Conducts new member welcome call within 30 days of the members enrollment into the plan, and provides a telephonic pre-screening to assess members social, psychological, and physical impairments. Conducts yearly follow up calls on members to re-evaluate members social, psychological, and physical impairments. Schedules routine and urgent PCP appointments. Identifies issues relating to Customer Service, Network Planning and Operations, Enrollment, Quality Assurance, and the Claims Department and communicates them through the proper channels for resolution.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>CENTRAL INTAKE SUPPORT SUPV</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8419]]></link>
<description><![CDATA[Provides direction and supervision to the Customer Service Representatives, Data Management Coordinators and Senior Data Management Coordinators. Plans, Coordinates, Manages, and Evaluates the Intake Coordination Process.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>SR PROGRAMMER ANALYST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8189]]></link>
<description><![CDATA[Defines, develops, tests, analyzes, and maintains software applications in support of the achievement of business requirements for Administrative Information Services. Researches, designs, documents, and modifies software specifications throughout the production life cycle. Works with network administrators, systems analysts, and software engineers to resolve problems with software products or internal systems and applications. Writes, translates, and codes software programs, scripts, and applications according to specifications. Designs and executes software performance tests; analyzes results and delivers solutions for problem areas. Directs work assignments and acts as a resource for junior level staff (Programmer Analysts and Business Analysts).Helps to manage interdisciplinary team during implementation and/or development projects. Makes sure tasks are completed by deadlines. Monitors costs of project to ensure they fall within budget.
We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>CLAIMS SUPERVISOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8165]]></link>
<description><![CDATA[Plans and supervises the activities of Claims Examiners within the Claims Department to ensure that department, plan, and regulatory requirements are met for output, quality, timeliness, and service. Resolves problems related to claims processing involving Medical Management, Network Development Services, Enrollment, Customer Services and other Claims related issues, as they arise. Monitors procedures and workflow and recommend changes to improve efficiencies regarding claims processing and payment. Monitors and develops inventory reduction plan as applicable to ensure timeliness and accuracy of claims output. Ensures that departmental/agency operates within established financial guidelines. Assures appropriate staffing to support departmental/agency services.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>PLACEMENT COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8281]]></link>
<description><![CDATA[Assign vendor services to newly enrolled HomeFirst and MAP members based on medically approved plans of care. Also coordinates the requests from members or providers to increase or decrease services. Works cooperatively with the Enrollment Department to obtain plans of care on a timely basis.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Employee tuition reimbursement
 403(b) retirement plan]]></description>
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<title>RETROSPECTIVE REVIEW COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8232]]></link>
<description><![CDATA[Responsible for the performance of the retrospective medical record review process. This employee will track, trend, reconcile, and collaborate with the Manager of Review Operations and other departments to coordinate the retrospective review process to ensure reviews are completed and the results are documented in the appropraite systems within designated timeframes.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>HOUSEKEEPING AIDE PART-TIME</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7690]]></link>
<description><![CDATA[Completes daily cleaning assignments to provide a clean, safe and comfortable physical environment for residents, employees and visitors, in accordance with all applicable laws, regulations and policies and procedures set by the facility. Clean, sweep, mop, vacuum, dust, sanitize and disinfect furniture, fixtures, walls and urinals as per assignment. Fills dispensers, dispose of trash and bio-waste materials, set up for resident/patient and department activities as necessary. Move furniture when necessary.
This is an 1199 represented position that offers an excellent compensation and benefits package.]]></description>
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<title>SENIOR FINANCIAL DATA ANALYST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8021]]></link>
<description><![CDATA[Analyzes and reports data related to various operational metrics in order to make recommendations for operational process improvements to senior management and other department heads. Assist in contract rate modeling by comparatively analyzing volume, case mix, industry benchmarks, ROI and optimizations. Monitor contracts and enforce provisions resulting in fee schedule reimbursement modifications. Assist in IPA relationship management including contract redevelopment, remodeling reimbursements, reassigning risk, monitoring fiscal viability. Evaluate and trend IPA spend rates, establish and secure adequate reserves, reestablishing Plan representation within the IPA community and introducing marketing concepts to grow panel/ memberships. Perform quaterly reconcilitations. Perform data case queries and informational updates. Report development by merging data and other data mining tools, on a routine or ad-hoc basis, using programs including, but not limited to , SQL and Crystal reporting.
We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>APPLICATIONS TRAINER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8190]]></link>
<description><![CDATA[This position will work directly with Elderplan management and business users to provide application training, understanding the various functions and assigned applications used within the organization, preparing application end-users to accomplish job results by planning, conducting, and evaluating application training, providing knowledge and expertise to application training solutions, working alongside and coordinating with other Information Services staff members and vendor personnel as required to support the strategic business plans of Elderplan.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>MANAGER NETWORK and CONTRACT DEVELOPMENT</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8299]]></link>
<description><![CDATA[Oversees provider contracting activities in upstate regions to ensure efficiency and maintain compliance with the company’s policies and standards and government laws and regulations. Responsible for day-to-day operations in the department to ensure a strong positive relationship with contracted providers (with primary focus on delegated vendors) and plan members.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>MANAGER OF REVIEW OPERATIONS</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7709]]></link>
<description><![CDATA[Elderplan, Inc. provides expanded Medicare health care coverage to seniors in all five boroughs for more than 20 years. Advance your career with us and enjoy outstanding stability, growth potential and a world of options.

Develops and implements departmental initiatives and oversees retrospective medical record reviews, both on-site and in provider settings. Oversee the categorizing and recording of each document associated with retrospective reviews in the appropriate system(s). Manages in-house staff, vendors and vendor contracts for retrospective review process. Ensures 95% or greater of appropriate determinations and recommendations for members based on established criteria including CAF/PRI compatibility, CM recommendations, and NHC recommendations. Implements, monitors, and evaluates NHC process. Trains and acts as a resource to all staff and makes recommendations for changes in policy, procedures, and workflows as deemed appropriate.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>SECURITY ADMINISTRATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8183]]></link>
<description><![CDATA[Administers user management for all application systems in the Elderplan portfolio, including setting up and removing system access for employees and system permitted users, maintaining application security and auditing user roles.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>AandG COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8390]]></link>
<description><![CDATA[Investigate and respond to written or verbal appeals and grievances submitted by members and providers in accordance with Contract Benefits and CMS and DOH regulations. Key responsibilities include determining the appropriate type of service, appeal or grievance, investigating and responding appropriately and within time guidelines, presenting cases for review and documenting all relevant information.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>PHARMACIST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8024]]></link>
<description><![CDATA[Elderplan, Inc. provides expanded Medicare health care coverage to seniors in all five boroughs for more than 20 years. Advance your career with us and enjoy outstanding stability, growth potential and a world of options.

Administer the Prescription Drug Benefit program. Key responsibilities include contract oversight, formulary management, pharmacy benefit development, benefit interpretation, profiling of cost and utilization plan data, provider relations and implementation of programmatic initiatives.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>MEMBER OPERATIONS MANAGER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7834]]></link>
<description><![CDATA[Responsible for day-to-day operations in the department to ensure potential and active membership Medicaid eligibility and accurate and timely submission of enrollment data.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>ASSOCIATE DIRECTOR OF VENDOR OVERSIGHT</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8442]]></link>
<description><![CDATA[Directs and oversees all oversight and compliance activities for delegated operations performed by contracted business partners, including, but not limited to, customer service, claims processing, and enrollment. Develops and administers a Delegation Oversight Program and Annual Workplan to monitor the performance of delegated business partners and to meet regulatory oversight and compliance requirements. Works under general supervision.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<title>RETENTION SPECIALIST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8405]]></link>
<description><![CDATA[Under the direction of the Retention Manager is responsible for various activities in support of the Sales Department. Job functions include member contact, Enrollment Counselor support, lead management and outgoing member calls.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
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<item>
<title>ACCOUNT MANAGER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8397]]></link>
<description><![CDATA[Under the direction of the HomeFirst Marketing Manager the Account Manager will seek qualified referrals fro HomeFirst within his/her assigned territory.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>APPLICATIONS BUSINESS ANALYST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8192]]></link>
<description><![CDATA[This position will work directly with Elderplan management and business users to provide business consulting and application support services, understanding the various functions and assigned applications used within the organization, providing knowledge and expertise to solve problems and develop solutions for and with business users, working alongside and coordinating with other Information Services staff members and vendor personnel as required to support the strategic business plans of Elderplan.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>APPLICATIONS BUSINESS ANALYST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8185]]></link>
<description><![CDATA[This position will work directly with Elderplan management and business users to provide business consulting and application support services, understanding the various functions and assigned applications used within the organization, providing knowledge and expertise to solve problems and develop solutions for and with business users, working alongside and coordinating with other Information Services staff members and vendor personnel as required to support the strategic business plans of Elderplan.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>PROVIDER ACCOUNT LIAISON</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8218]]></link>
<description><![CDATA[The Provider Account Liaison develops and maintains strong relationships with strategically important IPAs. The Provider Account Liaison coordinates with appropriate cross functional resources to ensure successful execution of the provider contract and the achievement of provider membership growth and financial results.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MEMBER SERVICES AUDITOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8410]]></link>
<description><![CDATA[In this role, an individual is responsible for quality assurance of the Member Services Staff and off-site vendors. Requirements will include, but are not limited to, monitoring call quality, appropriate work flow process and system utilization for the Member Service staff and for delegated offsite entities. He/She will also provide feedback through coaching to all audited entities including proper phone etiquette. The Member Service Auditor will work with the Director and Supervisor of Member Services to build a quality program for the Member Service staff and vendor oversight.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>HOSPICE CARE PLANNER PER DIEM</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=6908]]></link>
<description><![CDATA[Working on-site at a major medical center, the Hospice Care Planner is responsible for evaluating and establishing a plan of care for referred patients at the end stage of life. The Hospice Care Planner will facilitate admission of referrals upon discharge from the hospital to a home care program that meets the needs of the patient and family members. As a key member of the business development and marketing team the Hospice Care Planner develops and maintains positive relationships with physicians, social workers, case managers and discharge planners within the medical center.

home care, nursing, RN, homecare, nurse, home care nurse, home care RN]]></description>
</item>
<item>
<title>SOCIAL WORKER PER DIEM</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8376]]></link>
<description><![CDATA[Provides psychosocial support and other Social Work services to Hospice patients and their families in the inpatient, home care/nursing home settings, in pre and post bereavement phases of Hospice service. To serve as social work member of hospice IDG and as liaison between hospice staff and inpatient and nursing home staff. Develops social work plan of care, goals and makes recommendations based on patient/family needs for assigned patients who are direct admission to inpatient units or nursing home/hospice residents. To develop social work plan of care and discharge plans when appropriate for patients admitted into inpatient facility.

home care hospice, home care, sw, msw, social worker, social work, csw, hospice social worker]]></description>
</item>
<item>
<title>BENEFITS ADVISOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8250]]></link>
<description><![CDATA[Presents the Elderplan Benefit Package to 65+ population in order to enroll eligible participants into the plan in accordance to Elderplan and MJHS strategic goals. Presents Elderplan Benefits package to prospects in their home and at other locations in the community. Enrolls members in accordance with Elderplan, Medicare + Choice, Medicaid, New York State and AAHP Guidelines.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>INTAKE REFERRAL MANAGER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8454]]></link>
<description><![CDATA[Intake Referral Manager will provide direction and supervision to the Home Care Planners and Support Staff at NYP Columbia, The Allen Pavilion and through the MJHS system as needed. Plans, coordinates, manages, and evaluates the intake coordination process.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Employee tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MARKETING REPRESENTATIVE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8434]]></link>
<description><![CDATA[In accordance with the policies and regulations of New York State Department of Health, the Marketing Representative will plan and execute marketing initiatives designed to increase community awareness and advocacy for eligible HomeFirst Managed Long Term Care Plan (MLTCP) members.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>PROVIDER SERVICES COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8359]]></link>
<description><![CDATA[Responds to member and provider inquires and requests concerning benefits, claims and complaints within a call center environment in order to ensure high quality customer service to members and providers. Receives calls from members and providers. Responds to customers complaints and grievances. Records all calls and detail. Receives requests for adjustments on claim issues. Receives requests for disenrollment.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MARKETING REPRESENTATIVE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8314]]></link>
<description><![CDATA[Under the direction of the HomeFirst Marketing Manager the Marketing Representative will seek qualified referrals for HomeFirst within his/her assigned territory.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>TEAM ASSISTANT</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8416]]></link>
<description><![CDATA[Responsible for scheduling nurses. Manage referrals and monitor incoming referrals to ensure that all new cases are scheduled as appropriate. Coordinate Control Desk and maintain document control. Maintain records and accurately enter data. Cooperate with the nurses, PSMs and team to be successful in processing work, seeing patients, and creating satisfied customers. Assist Business Supervisor and PSM in working on reports.
We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>CREDENTIALING COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8449]]></link>
<description><![CDATA[Oversees the proper credentialing/recredentialing of all providers within the Home First network including but not limited to site visitation, application processing and information verification. Implements quality improvement. Responsible for the development and creation of provider contracts, provider manual and member network provider directory. Creates provider reports based on paid claims data. Oversees the daily management of sub-network agreement. Audits claims processing functions to determine error rate. Sends network providers correspondence regarding changes in the MLTCP.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MARKETING REPRESENTATIVE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8387]]></link>
<description><![CDATA[Under the direction of the HomeFirst Marketing Manager the Marketing Representative will seek qualified referrals for HomeFirst within his/her assigned territory.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>BENEFITS ADVISOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8433]]></link>
<description><![CDATA[Presents the Elderplan Benefit Package to 65+ population in order to enroll eligible participants into the plan in accordance to Elderplan and MJHS strategic goals. Presents Elderplan Benefits package to prospects in their home and at other locations in the community. Enrolls members in accordance with Elderplan, Medicare + Choice, Medicaid, New York State and AAHP Guidelines.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>HR ASSISTANT</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8374]]></link>
<description><![CDATA[We are looking for an enthusiastic, creative and energetic individual to support our HR team.  Duties for this role include overall administrative support for the HR department. Coordinate recruiting process and applicant tracking, pre-screen applicants by telephone and schedule interviews with HR and hiring managers as appropriate. Conduct employment verifications and background checks. Assist with Job Fairs. Professionally administer all incoming calls, direct calls appropriately; research employee questions, and respond to inquiries as needed.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>CLAIMS PROJECT COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8211]]></link>
<description><![CDATA[Coordinates and facilitates projects for Elderplan in an effort to resolve high priority provider issues. Projects, which can involve claims, authorization, pricing, or benefit issues, are assigned by Management and final results become part of the provider file.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>PROVIDER SERVICES REP</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8414]]></link>
<description><![CDATA[The individual within this role acts as a liaison between Elderplan and contracted providers to promote positive relationships with the Plan and enhance services to Plan members. He/She receives, assists and resolves all provider related complaints and appeals/grievances; responds to all provider inquiries via phone, fax, e-mail or regular mail; educates providers regarding benefits, policies and procedures including plan changes and updates; assists external departments with provider issues, claims, appeals and grievances; collaborates with Customer Service department regarding phone logs and providers issues; gathers changes in provider information or status (i.e. terminations; office hours; address changes; changes in after hours; holiday and vacation coverage, etc; and performs other tasks, as deemed necessary.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MANAGED CARE COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8306]]></link>
<description><![CDATA[Insure high quality, cost-effective care and services for Elderplan members through support of professional Care Management and/or Clinical Service activities. The position supports all aspects of care coordination for our Medicare, Medicaid, and/or dual product members in compliance with all departmental and regulatory requirements.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>ENTITLEMENT COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8452]]></link>
<description><![CDATA[Provides direct support to the Social Work Manager and other members of the Social Work department and the interdisciplinary care team with respect to Medicare and Medicaid eligibility. Evaluates individual for Medicaid Eligibility, and ensures Medicaid Application is complete. Prepares and coordinates the processing of Medicaid recertification packages. Tracks member Medicaid eligibility and recertification, assigns Staff Social Workers to cases, and coordinates paper documentation in member charts and billing records. Assists current enrollees with other entitlements such as Food Stamps and Section 8. Coordinates member hospitalization and nursing home admissions and discharges. Participates in periodic training on-site and in community.
We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>SENIOR BENEFITS ADVISOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7990]]></link>
<description><![CDATA[Presents the Elderplan Benefit Package to 65+ population in order to enroll eligible participants into the plan in accordance with Elderplan and MJHS strategic goals. Enroll members in accordance with Elderplan, CMS and New York State guidelines. Develop territory by creating and maintaining community relationships. Meet all stated departmental goals. Prepare necessary paperwork including enrollment forms, expense reports, daily activity reports and weekly activity sheets.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MARKETING REPRESENTATIVE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8435]]></link>
<description><![CDATA[In accordance with the policies and regulations of New York State Department of Health, the Marketing Representative will plan and execute marketing initiatives designed to increase community awareness and advocacy for eligible HomeFirst Managed Long Term Care Plan (MLTCP) members.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>CUSTOMER SERVICE REP</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8343]]></link>
<description><![CDATA[Serves as a liaison between Hospice Home Care Planners, Social Workers, and RN Case Managers and RN on call Triage Nurses. Responds to Social Work/RN Case Managers/patients/customers complaints and grievances.Takes accurate messages, problem solve where applicable and forwards to appropriate party as directed. Enters patient referral information into the Allscripts system including patient demographics, diagnosis and plan of care. Sends tasks to Team Assistants for Insurance Verification and to vendor services for DME and HHA . Verifys that all new physicians license number, NPI number is registered, and checks for duplicate physician before entering into Allscripts. Contacts Physicians/Clinics/ Hospitals/Nursing Homes/sub-acute facilities to develop/maintain/follow up on pending and/or new referrals.
We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>FEE FOR SERVICE FFS SOCIAL WORKER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8031]]></link>
<description><![CDATA[Assesses patient psycho-social issues to ensure adequate delivery of home care services in order to meet agency goals and required objectives. Obtains psycho-social history and conducts evaluation and assessment of patient including adequacy of patient support system. Provides supportive counseling in regards to emotional, psychological and concrete needs including discharge planning. Interprets and provides information about available benefits, entitlements and community programs to patients and family. Counsels patients and receommends community based resources regarding their psycho-social needs.]]></description>
</item>
<item>
<title>REGULATORY COMPLIANCE SPECIALIST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8242]]></link>
<description><![CDATA[Manages Compliance 360 based compliance workspace, incident tracking system and fraud, waste and abuse tracking system content and reporting; assists the AVP, Regulatory Compliance with managing compliance life-cycle process for multiple compliance activities, such as verifying implementation of new and revised regulations; compiles, tracks and analyzes measurement data (e.g., exclusions, training completion); prepares and maintains compliance reports and measurements tools (e.g., dashboards); coordinates new regulation implementation and audit projects; supports auditors and investigators in maintaining compliance and fraud, waste and abuse case files, correspondence and reports; and submits routine submissions to regulatory agencies.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>PATIENT FINANCIAL SERVICES COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8415]]></link>
<description><![CDATA[Processes data for financial reimbursement for the Home Care Division. Researches and resolves data entry problems incurred from the clinical/billing area and correct in back office software application. Prepares revenue and statistical reports as necessary.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MARKETING REPRESENTATIVE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7249]]></link>
<description><![CDATA[Under the direction of the Director of Long Term Options, and in accordance with the policies and regulations of New York State Department of Health, the Community Marketing Representative will plan and execute marketing initiatives designed to increase community awareness and advocacy for eligible HomeFirst Managed Long Term Care Plan (MLTCP) members.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>AandG COORDINATOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8320]]></link>
<description><![CDATA[Investigate and respond to written or verbal appeals and grievances submitted by members and providers in accordance with Contract Benefits and CMS and DOH regulations. Key responsibilities include determining the appropriate type of service, appeal or grievance, investigating and responding appropriately and within time guidelines, presenting cases for review and documenting all relevant information.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>CLAIMS EXAMINER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8223]]></link>
<description><![CDATA[Investigates and processes claims episodes based on claims information submitted by provider and departmental policies and procedures. Reviews, investigates and adjudicates claims for medical, facility, home health care, hospice and vision services which involve the application of contractual provisions in accordance with provider contracts, authorizations and Medicare regulations. Processes claim suspensions from the system to correct processing discrepancies and other edits by reviewing online information. Investigates, intervenes, communicates and follow-up orally or in writing with a variety of internal and external sources. Evaluates claims to ensure payments are for the services rendered. Evaluates DRG grouping and pricing information. Analyzes patient and medical information to identify COB, Workers Compensation, No-fault and Subrogation conditions and coordinates benefits with other carriers, when applicable. Processes adjustments to claims.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>SENIOR BENEFITS ADVISOR</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7989]]></link>
<description><![CDATA[Presents the Elderplan Benefit Package to 65+ population in order to enroll eligible participants into the plan in accordance with Elderplan and MJHS strategic goals. Enroll members in accordance with Elderplan, CMS and New York State guidelines. Develop territory by creating and maintaining community relationships. Meet all stated departmental goals. Prepare necessary paperwork including enrollment forms, expense reports, daily activity reports and weekly activity sheets.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MARKETING REPRESENTATIVE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8393]]></link>
<description><![CDATA[Under the direction of the HomeFirst Marketing Manager the Marketing Representative will seek qualified referrals for HomeFirst within his/her assigned territory.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MARKETING REPRESENTATIVE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8331]]></link>
<description><![CDATA[Under the direction of the HomeFirst Marketing Manager the Marketing Representative will seek qualified referrals for HomeFirst within his/her assigned territory.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MANAGER OF CONTRACT and NETWORK DEVELPMENT</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8441]]></link>
<description><![CDATA[Oversees provider contracting activities in upstate regions to ensure efficiency and maintain compliance with the company’s policies and standards and government laws and regulations. Responsible for day-to-day operations in the department to ensure a strong positive relationship with contracted providers (with primary focus on delegated vendors) and plan members.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>MANAGER OF HOSPITAL and GROUP CONTRACTING</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8301]]></link>
<description><![CDATA[The individual within this role is responsible for the day-to-day operations of the department to ensure a strong positive relationship with contracted providers, with primary focus on delegated vendors, and plan members. He/She will also be responsible for managing the Part D requirements for CMS both through the vendor/PBM and with internal staff, along with managing the interface between Plan staff and the vendor/PBM, and conducting financial analysis to support recommendations for changes to benefits. Additionally, this individual will manage performance of direct and indirect reports, provide orientation, coaching, training and development.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>SOCIAL WORKER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8421]]></link>
<description><![CDATA[Assesses patient psychosocial issues to ensure adequate delivery of home care services in order to meet agency goals and required objectives. Provides supportive counseling. Provides concrete services and related counseling. Conducts Home visits in a timely manner. Coordinates activities with other health team members to ensure optimal patient care and communication of pertinent findings.
We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>FEE FOR SERVICE FFS SOCIAL WORKER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8030]]></link>
<description><![CDATA[Assesses patient psycho-social issues to ensure adequate delivery of home care services in order to meet agency goals and required objectives. Obtains psycho-social history and conducts evaluation and assessment of patient including adequacy of patient support system. Provides supportive counseling in regards to emotional, psychological and concrete needs including discharge planning. Interprets and provides information about available benefits, entitlements and community programs to patients and family. Counsels patients and receommends community based resources regarding their psycho-social needs.]]></description>
</item>
<item>
<title>MANAGER, REGULATORY COMPLIANCE</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7669]]></link>
<description><![CDATA[Research current and proposed state and federal regulations and industry standards applicable to the organization; summarize and communicate regulatory and industry standards to Elderplan management and staff; and assist Elderplan management in the preparation and dissemination of regulatory requirements and updates to departments, as appropriate. Faciltiate, attend and/or participate in orgainzational committees, workgroups and meetings, as necessary, including but not limited to, the Compliance Committee, Quality Improvement Committee. Conduct compliance audits.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>AandG SPECIALIST</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8369]]></link>
<description><![CDATA[Handles department correspondence and provides back-up support to Dept. secretary in order to insure that grievances and appeals are processed within established regulatory time frames and in accordance with Agency and department standards. Processes department mail, including incoming and outgoing mail. Opens, date stamps and logs all incoming mail. Prioritizes and distributes correspondence to appropriate individual. Prepares and maintains departmental files.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>HOSPICE CARE PLANNER PER DIEM</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=6906]]></link>
<description><![CDATA[Working on-site at a major medical center, the Hospice Care Planner is responsible for evaluating and establishing a plan of care for referred patients at the end stage of life.  The Hospice Care Planner will facilitate admission of referrals upon discharge from the hospital to a home care program that meets the needs of the patient and family members. As a key member of the business development and marketing team the Hospice Care Planner develops and maintains positive relationships with physicians, social workers, case managers and discharge planners within the medical center.

home care, nursing, RN, homecare, nurse, home care nurse, home care RN]]></description>
</item>
<item>
<title>MARKETING REP - ORANGE/ROCKLAND</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=7975]]></link>
<description><![CDATA[In accordance with the policies and regulations of New York State Department of Health, the Community Marketing Representative will plan and execute marketing initiatives designed to increase community awareness and advocacy for eligible HomeFirst Managed Long Term Care Plan (MLTCP) members.

We truly value our staff and further acknowledge their contributions by offering:
 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
<item>
<title>ACCOUNT MANAGER</title>
<link><![CDATA[http://mjhs.jobs/JobDetail.aspx?jobid=8394]]></link>
<description><![CDATA[Under the direction of the HomeFirst Marketing Manager the Account Manager will seek qualified referrals fro HomeFirst within his/her assigned territory.

We truly value our staff and further acknowledge their contributions by offering:

 Employee and family health coverage
 Competitive salaries
 Employer contributed pension plan
 Generous time off
 Tuition reimbursement
 403(b) retirement plan]]></description>
</item>
</channel>
</rss>
