Placement & Utilization Support Coordinator III

MJHS • New York, NY

4d

About The Position

The Placement & Utilization Support Coordinator is expected to provide a high quality of customer service. The position requires the coordinator to act as a liaison between the vendors and both the Care Management and Enrollment Department. Coordinators will authorize services based on medically approved plans of care and information provided within the interdepartmental communication system to newly enrolled and existing HomeFirst and MAP members. Coordinators will also process the dis-enrollment of existing HomeFirst & MAP members. The position demands excellent communication and documentation skills to help facilitate excellent customer service. 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. Benefits include: 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 And MORE! MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Requirements

• One year of related Customer Service Experience.
• Familiarity with utilization management/case management HealthRules Payor, HHAX, Guiding Care, Word and Excel, Type an Average of 55 wpm.
• Good customer service skills.
• Ability to be empathetic and understanding.
• Excellent written and oral communication skills.
• Good analytical abilities.
• Ability to handle confidential aspects of the position.
• Ability to work closely with different professionals as part of an interdisciplinary health care team.
• Appropriately allocates resources, maximizes efficiency, and contains costs.
• Ability to work independently while recognizing issues having departmental or organizational impact.
• Assess members’ needs and identify opportunities for recommending alternative levels of care.
• Ability to maintain collegial relationships and work in a interdisciplinary team environment.

Nice To Haves

• Prior experience in a health care setting preferred.

Responsibilities

• Works cooperatively with the Claims Department to provide resolution to timely and untimely filing.
• Works cooperatively Provide email communication of adjudication outcome with the Appeals & Grievance Department in the appeal determination.
• Performs department coverage resolving provider concerns by acting department advocates when necessary.
• Assist department with training and developing in the new hire process.
• Obtain department documents and follow with internal and external customers

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)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 1,001-5,000 employees