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Utilization Management Support Supervisor

MJHS
MJHS Salary
New York, NY Full Time
POSTED ON 4/6/2025
AVAILABLE BEFORE 5/5/2025

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 :

Provides daily oversight of the Utilization Management Support Services unit. Responsibilities include, but are not

limited to staffing, call monitoring, quality assurance / process monitoring, customer problem resolution, enrollment, and

provider relations. Works with the management team of Coordinated Care in creation and implementation of shared

projects and workflows to ensure compliance with NYS DOH and CMS regulations. Responsible for oversight of service

authorizations and admission / discharge documentation processing. Assists staff in managing caseloads and provides

ongoing monitoring of staff productivity, attendance, and quality of work.

Qualifications :

  • Baccalaureate Degree preferred, 3 to 4 years’ experience in healthcare
  • 4-5 years’ experience in business, human services, or a health-related field
  • 2 years supervisory experience preferred.
  • 2-3 years’ experience in provider relations and / or member services in managed

care.

  • Prior experience with Medicaid managed care.
  • Knowledge of the service delivery needs of the elderly, chronically ill or
  • disabled.

  • Working knowledge of Windows, Word, Excel and care management / utilization
  • management software systems

  • Strong interpersonal and organizational skills
  • Excellent written and verbal communication skills
  • Excellent analytic skills, interpretation of data
  • Possess strong critical thinking skills and knowledge of Medicare and Medicaid
  • regulations.

  • Work effectively within interdisciplinary team environment
  • Ability to set priorities and to handle multiple assignments.

  • Working knowledge of audit techniques and methodologies
  • Working knowledge of State and Federal regulations
  • Possess good judgment and sense of urgency
  • Ability to secure relevant information to identify potential problems, escalate, and
  • make recommendations for appropriate solutions

    Salary : $61,463 - $73,756

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