• Supervisor, Concurrent Review

    Job Locations US-NY-Brooklyn
    Req #
    107273
    Agency
    Elderplan
    Status
    Regular Full-Time
    Location : Postal Code
    11220
    Category
    Management - Clinical
    Office or Field
    Office-based
  • 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.

    Why work for MJHS?

    When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No?  You will here!  You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals.  You take care of our patients, residents and health plan members, and we will take care of the rest!

     

    Benefits include:

    • Sign-on Bonuses OR Student Loan Assistance for clinical staff
    • FREE Online RN to BSN and MSN degree programs!
    • Tuition Reimbursement for all full and part-time staff
    • Dependent Tuition Reimbursement for clinical staff!
    • Generous paid time off
    • Affordable medical, dental and vision coverage for employee and family members
    • Two retirement plans! 403(b) AND Employer Paid Pension
    • Flexible spending
    • And MORE!

    Responsibilities

    Provides quality, cost-effective care to all members through the direct supervision of staff responsible for the management and coordination of the member's care through the incorporation of interdisciplinary strategies, medicare regulations, and medically accepted standards of care. Supervises the assessment of all acute and sub-acute inpatient care for appropriateness of setting and services, according to pre-established criteria and guidelines and ensure a 95% compliance or greater. Supervises the assessment and coordination of the members physical, psychosocial and discharge planning needs through communication with appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners. Assures appropriate staffing to support departmental/agency services. Ensures all employees are oriented to their department/agency and job and provided with appropriate training, development and continuing education. Correctly interprets and applies all Human Resources policies and procedures relative to discipline, recruitment and selection, performance appraisals, salary reviews and staffing.

    Qualifications

    Bachelor's Degree in Nursing. Minimum one to three years previous management experience preferred. Previous managed care experience in the areas of utilization management and/or case management required. Working knowledge of Windows, Word, Excel. Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies.

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