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.

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 to diverse populations. We foster collaboration, celebrate achievements, and promote diversity, equity, and inclusion. 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)

Responsible for managing day-to-day activities of the Member Operations staff. Analyzes existing procedures and develops workflows and processes based on analysis and regulatory changes, and communicates these changes to staff. Manages the internal audit processes and recommends appropriate action. Generates, maintains and distributes member eligibility files to vendors by the secure means and according to the distribution schedule specified by the vendor. Prepares for, and participates in, external regulatory audits (e.g. DOH, DOI, and CMS). Assist the Director with the production of the monthly board reports.

• Bachelor's degree required, Master's degree preferred
• Two years experience in a supervisory role preferred
• Proficiency in MS office (Access, Excel, PowerPoint, Word) required; experience with AMISYS, Market Prominence, Crystal Reports preferred
• Knowledge of managed care organizations, CMS and Federal regulations
• Ability to multitask, think and act independently, delegate appropriately
• Detailed oriented and analytical