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

RGZQc2d5YWZiMGhES3FpVmFwK1NrUFdFNGc9PQ==
  • 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

Providence Health and Services

Occupational Therapist Job at Providence Health and Services

 ...Occupational Therapist at Providence Health and Services summary: An Occupational Therapist at Providence Santa Rosa Memorial Hospital...  ..., neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit... 

Convergenz

Construction Project Manager Job at Convergenz

 ...Program Manager shall possess a minimum of fifteen (15) years of experience leading programs...  ...of this size and scope, life-cycle CMa project management experience from inception to...  ...team supporting multiple large-scale construction projects. Must be able to obtain a CBP Public... 

Illinois Staffing

HR Generalist Job at Illinois Staffing

 ...environment where you can make an impact. With interesting opportunities in engineering, marketing, sales, supply chain, operations, HR, finance, and more across more than 40 diverse businesses around the globe, chances are, we have something special for you. The position... 

D.R. Horton

Office Assistant/Receptionist Job at D.R. Horton

 ...founded in 1978 and is a publicly traded company on the New York Stock Exchange. It is engaged in the construction and sale of high quality homes designed principally for the entry-level an Office Assistant, Receptionist, Assistant, Construction, Business Services, Office... 

Tropigas de Puerto Rico Inc

Automotive Mechanic Job at Tropigas de Puerto Rico Inc

Job Description Job Description Departamento : Taller Personas a cargo : n/a Posiciones Disponibles : Varias Localizaciones : Gurabo Sobre la posicin Estamos en bsqueda de Mecnicos" para trabajo a tiempo completo en nuestro taller en Gurabo con veh...