Manager of Community Based Long Term Care Support

Overview

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.

Why work for MJHS?

When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No?  You will here!  You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals.  You take care of our patients, residents and health plan members, and we will take care of the rest!

 

Benefits include:

• Tuition Reimbursement for all full and part-time staff
• Generous paid time off
• Affordable medical, dental and vision coverage for employee and family members
• Two retirement plans! 403(b) AND Employer Paid Pension
• Flexible spending
• And MORE!

MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Responsibilities

Responsible for the daily management and oversight of all Placement and Utilization Support unit functions including but not limited to service authorizations, request/issue processing, and enrollment processing. Assists in problem-solving as new duties arise, and volumes fluctuate. Responsibilities include hiring new staff/team building, ongoing monitoring of staff productivity and attendance, and quality of unit output. The Manager will have oversight of the quarterly re-authorization process (A.K.A Budget Load), ensuring timely completion, process improvement, and authorization integrity. Work with the HHA exchange team to explore and utilize current functionality while evaluating and assisting in the development of additional functionality to support unit activities. The position demands excellent communication and documentation skills to ensure and foster unit outcome excellence.  Provides support to the Assistant Director of Clinical Support Services in the creation and implementation of new projects, policies, and workflows to ensure full compliance.

Qualifications

• Baccalaureate Degree preferred, 3 to 5 years’ of related  work experience in healthcare required.
• 3-5 years experience in business, human services, or a health-related field.
• 2-3 years’ experience in provider relations and/or member services in managed care. Prior experience with Medicaid managed care.
• 2+ years of leadership experience.
• Demonstrates knowledge/ability of: Institutional goals and changing trends in healthcare and Cost factors in delivering patient care.
• Proficiency in MS Word, Excel and knowledge of Telephony and Windows operating systems.
• Knowledge of new trends in Clinical Management and be able to apply data processing HealthRules Payor, HHAX, Guiding Care
• Type an Average of 55 wpm.
• Good customer service skills.
• Excellent written, oral communication and analytical abilities.

Min

USD $77,099.34/Yr.

Max

USD $92,519.21/Yr.