What are the responsibilities and job description for the Pre-Authorization Unit Supervisor position at MJHS?
Req # : 1942
Job ID : 13490
Job Location : New York, NY
Zip Code : 10041
Category :
Management - Clinical
Agency : Elderplan
Status : Regular Full-Time
Office : Hybrid
Salary :
101,503.41 - $126,879.27 per year
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 :
- Tuition Reimbursement for all full and part-time 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!
MJHS companies are qualified employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF)
Responsibilities :
The supervisor in this position is responsible for the oversight of the overall day to day functioning of the MLTC / DSNP pre-authorization functions.The supervisor's daily oversight includes reviewing data to monitor regulatory requirements (standard / expedited time frames, org determination outcomes and communication, inter-rater reliability), provides direction for complex cases, monitors pending cases, reviews and educates staff on new criteria trends (including InterQual, local carrier policy, national coverage determinations), and acts as a liaison with interdepartmental communication.
Qualifications :
Salary : $101,503 - $126,879
