MetroPlusHealth Jobs in United States

The Salesforce Analyst is accountable for performing analysis and administrative support specifically to Salesforce (SF) for the Claims Department. · Scope Of Role & Responsibilities · Under direction from manager coordinates the administration aspects of the Salesforce tool and ...

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. · The Health and Recovery Plan (HARP) Care Manager develops, facilitates, and communicates a plan of care in partnership with the member, · their assigned Health Home, primary caregiver, · ...

+Product Manager,Audit and Complaints+The Product Manager, Audit and Complaints ensures operational excellence and regulatory compliance in working with cross departmental teams to ensure Regulatory and Compliance Audits and Complaints are researched and responded to timely. · +L ...

Position Overview · The BH Claims Supervisor will oversee personnel involved in the adjudication of behavioral health-related medical claims. This position will provide support to the ASP Manager and other MetroPlusHealth employees regarding the adjudication of complex, difficult ...

MetroPlus Health is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. · Negotiate contracts and manage relationships with participating Hospitals, IPAs, Ambulatory Surgery Centers, SUD sites, Behavior ...

Care Manager Social Worker · Empower members through compassionate care · Collaborate with healthcare providers to optimize member health outcomes · The Care Manager will engage with members, assess their needs, and develop personalized plans to improve their well-being. This ro ...

Position Overview · The Claims Supervisor is responsible for the daily oversight of Medicare claims processes including but not limited to the inquiry and resolution process, adjudication process, user acceptance testing and quality assurance, training, and reporting. In addition ...

Empower. Unite. Care. · MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what y ...

Job Description · The Data Engineer position in the Analytics and Reporting Department manages encounter data submission to NYSDOH CMS and other regulatory entities as required. · Maintains EDI mapping issues troubleshooting Encounter data reporting errors monitoring Encounter Da ...

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. · Clinically assess members for acute behavioral and physical health needs. · Generating referrals to providers, community-based re ...

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that health care is a right, not a privilege. · We offer competitive benefits including comprehensive health benefits for employees hired to work 20+ hrs per week and retirement ...

Job Description · The Data Engineer in the Analytics and Reporting Department manages encounter data submission to NYSDOH, CMS, and other regulatory entities. Responsibilities include troubleshooting EDI mapping issues, Encounter data reporting errors, monitoring Encounter Data Q ...

This highly technical role is suited for a candidate with hands-on analytical experience as a network security engineer with the following background: · Network routing and switching · Network security appliances and applications · Site-To-Site VPN, client VPN, and encryption/dec ...

Position Overview · The Salesforce Analyst is accountable for performing analysis and administrative support specifically to Salesforce (SF) for the Claims Department. Incumbent will triage new cases and route/reroute cases as needed, assign salesforce cases to staff, will monito ...

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. · Provides clinical guidance and supervision to all care management programs. · Mentor Health and Wellness Advisors and Clinical Ca ...

Drive client satisfaction by managing ongoing relationships and service delivery to client accounts. · Serves as the primary point of contact for overall & day-to-day service delivery by working closely with internal and external stakeholders. · ...

MetroPlusHealth está comprometido con empoderar a los neoyorquinos uniéndolos mediante atención médica. Si tienes compasión y un espíritu colaborativo, trabaja con nosotros. Puedes venir al trabajo sintiéndote orgulloso de lo que haces todos los días. · ...

Lorem ipsum dolor sit amet, · consectetur adipiscing elit. · Suspendisse faucibus ultrices nulla, · quis sagittis nibh rutrum vel.Analyze claim and encounter data to ensure data submission is meeting regulatory requirements. · Reconcile data with regulatory reporting and gap anal ...

The Support Driver is responsible for operating and maintaining company vehicles. The role will primarily provide support to all aspects of the Sales and Customer Success Departments' outreach and enrollment efforts. · ...

The Product Specialist ensures operational excellence and regulatory compliance owning the full spectrum of product member materials and across all Product Lines. · Bachelor's degree from an accredited college or university in an appropriate discipline required. · Master's degree ...