About The Position

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. The MJHS Difference At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.

Requirements

  • Minimum of 5 years of clinical experience
  • Managed Care Experience
  • Board Certification in a General Practice, Internal Medicine, Primary Care or Geriatrics
  • Practical understanding and strong commitment to managed care
  • Knowledge of Quality Assurance, Utilization Review, program development and implementation skills
  • Strong communication and leadership skills

Responsibilities

  • Acts as a medical resource to the health plan, directing clinical and government mandated utilization and quality improvement efforts.
  • Responsible for the consistent, effective use of clinical guidelines and clinical nursing rounds.
  • Monitors quality and the appropriateness of medical care.
  • Collaboration on clinical program development in concert with the operational leadership of the plan.

Benefits

  • Tuition Reimbursement for all full and part-time staff
  • Generous paid time off, including your birthday!
  • Affordable and comprehensive medical, dental and vision coverage for employee and family members
  • Two retirement plans !
  • 403(b) AND Employer Paid Pension
  • Flexible spending
  • MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)
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