About this opportunity
Metropolitan Jewish Health System lists this A&G RN Coordinator opportunity in new york, New York. Review the employer’s description below for duties, qualifications and application requirements.
Job description
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.
The RN Coordinator will investigate and respond to written and/or verbal clinical appeals, expedited clinical grievances and potential quality of care grievances submitted by members and providers in accordance with Elderplan Contract Benefits, CMS (Centers forMedicare & Medicaid Services), and DOH (Department of Health) regulations.
Graduate of accredited nursing program; BSN preferred
2 years managed care or hospital based ulilization/case management experience
2 years minimum clinical experience
Licensed nurse in New York State
Proficiency withMicrosoft Word, Excel, Power Point and Outlook is required
Must have excellent written ad verbal communication skills
Must be comfortable researching current evidence based practice guidelines and protocols
Must be able to multi-task and managed multiple projects efficiently, meet deadlines, demonstrate analytical/critical thinking skills, and provide excellent customer services that leads to positive problem resolution
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.