A&G RN Coordinator Job at MJHS, New York, NY

cmlvOTFCOTNmOStvdDdiNlMrWUhsYkFxNHc9PQ==
  • MJHS
  • New York, NY

Job Description

Job Description

Job Description

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

The RN Coordinator will investigate and respond to written and/or verbal clinical appeals, expedited clinical grievances and potential quality of care grievances submitted by members and providers in accordance with Elderplan Contract Benefits, CMS (Centers for Medicare & Medicaid Services), and DOH (Department of Health) regulations.

  • Graduate of accredited nursing program; BSN preferred
  • 2 years managed care or hospital based ulilization/case management experience
  • 2 years minimum clinical experience
  • Licensed nurse in New York State
  • Proficiency with Microsoft Word, Excel, Power Point and Outlook is required
  • Must have excellent written ad verbal communication skills
  • Must be comfortable researching current evidence based practice guidelines and protocols
  • Must be able to multi-task and managed multiple projects efficiently, meet deadlines, demonstrate analytical/critical thinking skills, and provide excellent customer services that leads to positive problem resolution

Job Tags

Contract work,

Similar Jobs

Express Employment - Fairfield, CA

Auto Mechanic Job at Express Employment - Fairfield, CA

 ...Auto Mechanic / Automotive Technician Job Summary: Responsible for diagnosing, repairing, and maintaining a wide range of vehicles to ensure safe, reliable operation. Performs mechanical and electrical repairs, preventative maintenance, and inspections in accordance... 

ATC West Healthcare Services

Certified Registered Nurse Anesthetist (CRNA) Job at ATC West Healthcare Services

 ...5x8s, 4x10s, or 3x12s (flexible scheduling) Weekends-only shifts also accepted GI-specific schedule...  ...10s) Hours: 40 hours/week guaranteed unless time off is requested Call/Holidays: No call; holidays off Part-Time: Accepted (Full-Time preferred) Job... 

Syracuse Regional Airport Authority

Airport Police Officer- Part Time Job at Syracuse Regional Airport Authority

 ...Part-time Airport Police Officers Syracuse Regional Airport Authority (SRAA), operator of Syracuse Hancock International Airport,...  ...hour, plus shift differential New York State Police and Fire Retirement System (PFRS) Plan 384d NYS Deferred Compensation Plan (457b... 

FIRST SOFTSOLUTIONS INC

Java Front End Developer Job at FIRST SOFTSOLUTIONS INC

 ...environments, for development, staging/ QA and one for Production. Responsible for deployment of the UI module to production using Aws amplify. Responsible for Auth module implementation integrating it with SSO approach with Azure AD + Amplify +Cognito Implemented role... 

MOXTEK

Environmental, Health & Safety Engineer Job at MOXTEK

 ...Summary: Lead the technical development and implementation of environmental, health, and safety programs. Ensure compliance with local, state, and...  ...environmental management. When staffed, provide directions to an intern responsible for environmental regulation tasks. Key...