The Customer Services Quality Assurance Analyst (QAA) is responsible for assessing the quality of the performance of our call center representative who deal with our existing and potential customer. The QAA will be responsible for ensuring that our Customer Services Representatives are meeting expectations as detailed in the departmental policies and procedures. This indi

Provide technical administrative support for all network development and contracting activities. The primary focus of the position will be on outreach, recruitment, and contracting of Behavioral Health providers Job Description Research and Prepare provider contracts after credentialing is completed in Contract Lifecycle Management System (CLM). Build and maintain relatio

The Salesforce Architect will lead efforts to adapt and Salesforce, offer support to our business and responsible for a wide variety of critical applications built on Salesforce platform. The Salesforce Architect will also provide oversight and responsibility for the performance and operation of the Salesforce Development team through management, leadership, and mentorshi

Medicare Care Managment Team Lead (RN) Job Ref 96281 Category Utilization Review and Case Management Department CASE MANAGEMENT PROGRAM Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Salary Range $100,000.00 $110,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities th

Medicare Sales Representatvie II Job Ref 107457 Category Sales Department FACILITATED ENROLLMENT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $56,000.00 Salary Range $56,000.00 $64,911.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We be

MetroPlus Health is seeking a Business Transformation Lead who will help drive the way we conduct and operate traditional business functions, challenging the status quo and injecting innovative thought leadership to improve operational efficiencies and lead the flawless execution. The Business Transformation Lead will partner with our cross function stakeholders to introd

Medicaid Care Manager Team Lead (RN) Job Ref 98746 Category Utilization Review and Case Management Department CASE MANAGEMENT PROGRAM Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Salary Range $100,000.00 $110,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities thro

Under the supervision of the Manager of MLTC PCS Care Management Associates, the CMA Supervisor is responsible for the supervision of the Care Management Associates within the MLTC Department. The CMA Supervisor monitors the CMA departmental ACD phone queue to ensure quality of calls between the Care Management Associates, members, and providers. The CMA Supervisor conduc

Reporting to the Director of Growth Operations, the Administrative Coordinator is responsible for providing analytical, operational, and administrative services to Growth Field Operations based on assigned units/regions (Brooklyn, Queens, Emerging Markets, Manhattan/Staten Island, or the Bronx/Recovery Unit). The Administrative Coordinator performs a wide range of complex

The Care Manager develops, facilitates, monitors, and communicates a care plan in partnership with the member, his/her family or significant other, primary caregiver, the primary and/or the attending physicians, and various providers. Using the assessments and interview done by the Assessment Nurse, the Care Manager identifies the risk factors, strengths, challenges, and

The primary goal of the Transitions of Care (TOC) Care Manager is to provide care coordination services as members move from one setting to another. Examples of these settings include inpatient facilities, emergency department, rehabilitation facilities, long term care facilities, and certified home health agencies. The goal is to prevent re admissions and reduce avoidabl

The Care Management Associate, under the direction of the CMA Supervisor, is responsible for the daily activities of the member case intake functions and associated workflow, as well as for performing other duties associated with the coordination of member care as outlined for the MLTC/PCS Team. Job Description Handles both incoming and outgoing calls on the MLTC/PCS ACD

Quality Management Health Navigator Job Ref 106120 Category Member Services Department QUALITY MANAGEMENT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $50,000.00 Salary Range $50,000.00 $60,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through ca

MetroPlus Health seeks an Instructional Designer who has a passion for creating engaging, innovative, and effective learning solutions. The individual in this role will provide leadership and support for the development of the learning curriculum via different mediums. These mediums may include, but are not limited to, e learning, in class learning, presentations, etc. Jo

Product Implementation Specialist Job Ref 103924 Category Professional Department MHP PRODUCT Location 50 Water Street, 7th Floor, New York, NY 10004 Job Type Regular Employment Type Full Time Hire In Rate $75,000.00 Salary Range $75,000.00 $85,000.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We belie