Product Implementation Specialist Job Ref 103924 Category Professional Department MHP PRODUCT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $75,000.00 Salary Range $75,000.00 $85,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We belie

Quality Management Analytics Manager Job Ref 102881 Category Quality Assurance Department QUALITY MANAGEMENT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $121,000.00 Salary Range $121,000.00 $131,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities thro

Educate and enroll Medicaid eligible for the MetroPlusHealth Managed Long Term Care product. Identify eligible Medicaid consumers via Home Care Agencies, Adult Day Care Centers, DME Provider offices, Caregiver Resources Centers, specialty provider offices, HHC Long Term Care Facilities, etc. Understand and apply all policies and procedures pertaining to Disclosures and pr

The Project Manager II (PM II) will be responsible for developing and overseeing the operational aspects and scope of a project, generally with system wide implications. The PM II creates and executes project plans and business requirements. They also effectively apply project methodology and enforce standards while ensuring quality assurance procedures. Job Description O

Senior Director of Call Center Managed Care / Health Plan Job Ref 107316 Category Call Center Department CALL CENTER Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $125,000.00 Salary Range $125,000.00 $200,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communit

Director of State Regulatory Compliance Job Ref 107288 Category Compliance and Regulatory Department OFFICE CORPORATE COMPLIANCE Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $160,000.00 Salary Range $160,000.00 $170,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by unit

Children's BH Care Manager (LMSW, LCSW, LMHC) Job Ref 107008 Category Utilization Review and Case Management Department MHP CHILDRENS PROGRAM Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $83,000.00 Salary Range $83,000.00 $83,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorke

Medicare Sales Representative II Job Ref 105948 Category Sales Department FACILITATED ENROLLMENT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $64,911.00 Salary Range $64,911.00 $64,911.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We be

The purpose of this position is to provide analysis as well as monitor, guide and enhance the processes related to the assessment, build and ongoing maintenance of providers, groups, and IPAs for new and existing contracts. This role requires intra departmental communication, process management and collaboration with our Contracting, Credentialing, Provider Network Operat

The Care Manager Level II is the experienced, role model, and efficient member of the Case Management Program team. The Care Manager II works hand and hand to provide support and assistance to Level 1 Care Managers when needed, acting as a preceptor in the Department. With the goal of optimizing members' health care and delivery of care experience and improving quality of

The Payment Integrity (PI) Analyst will assist in the development of a strategic roadmap to recover, eliminate, and prevent unnecessary medical expense spending and support the execution for a comprehensive claim accuracy program. The incumbent will optimize pre/post claim editing, auditing, and claim recovery programs that will drive incremental value year over year. The

Labor and Employee Relations Business Partner Job Ref 106221 Category Human Resources Department HR OPERATIONS Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $95,000.00 Salary Range $95,000.00 $105,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities thro

The primary goal of the Care Manager is to optimize members' health care and delivery of care experience with expected cost savings due to improved quality of care. This is accomplished through engagement and understanding of the member's needs, environment, providers, support system and optimization of services available to them. Care Manager is expected to assess and ev

The primary goal of the Care Manager is to optimize members' health care and delivery of care experience with expected cost savings due to improved quality of care. This is accomplished through engagement and understanding of the member's needs, environment, providers, support system and optimization of services available to them. The Care Manager is expected to assess an

The security engineer is responsible for implementing, maintaining, monitoring and managing secure solutions. The engineer delivers these solutions in accordance with the organization's architectural designs, best practices, and regulatory or compliance requirements. As risks change, the security engineer is responsible for recommending modifications and enhancements to e