Address
Form of workOverview
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:
MJHS companies are qualified employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF)
Responsibilities
The Entitlement Coordinator maintains up-to-date knowledge of HomeFirst Managed Long Term Care Plan (MLTCP) and the entitlement process. Entitlement Coordinator is responsible for conducting mail and telephonic outreach to verify and assist in the Medicaid enrollment eligibility of a Prospect. This individual coordinates Nursing Home discharges with HRA/LDSS, the Nursing Home, HomeFirst Clinical Enrollment and UM departments, and the prospect/caregiver. Entitlement Coordinator reviews, analyzes, and reconciles all enrollment files from Maximus, including rejections, and compares them to Homefirst Upload files.
This individual proactively troubleshoots and coordinates with HRA/LDSS to ensure the accuracy of outgoing and incoming eligibility information and provides solutions to issues as they arise. Entitlement Coordinator has extensive knowledge of HRA/LDSS and NY state systems, such as eMedNY / ePaces and knows how to utilize these systems to confirm enrollment eligibility. This individual is responsible for assisting in the oversight and maintenance of all logs & reports associated with Entitlement, which delineate productivity, timeframes, and quality of HomeFirst Enrollment's Entitlement processes and outcomes. Entitlement Coordinator adheres to all HIPPA standards and confidentiality requirements and is responsible for problem solving as new duties arise and volumes fluctuate.
Qualifications
Min
USD $42,400.61/Yr.
Max
USD $53,000.76/Yr.
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:
- Sign-on Bonuses OR Student Loan Assistance for clinical staff
- FREE Online RN to BSN and MSN degree programs!
- Tuition Reimbursement for all full and part-time staff
- Dependent Tuition Reimbursement for clinical 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 Entitlement Coordinator maintains up-to-date knowledge of HomeFirst Managed Long Term Care Plan (MLTCP) and the entitlement process. Entitlement Coordinator is responsible for conducting mail and telephonic outreach to verify and assist in the Medicaid enrollment eligibility of a Prospect. This individual coordinates Nursing Home discharges with HRA/LDSS, the Nursing Home, HomeFirst Clinical Enrollment and UM departments, and the prospect/caregiver. Entitlement Coordinator reviews, analyzes, and reconciles all enrollment files from Maximus, including rejections, and compares them to Homefirst Upload files.
This individual proactively troubleshoots and coordinates with HRA/LDSS to ensure the accuracy of outgoing and incoming eligibility information and provides solutions to issues as they arise. Entitlement Coordinator has extensive knowledge of HRA/LDSS and NY state systems, such as eMedNY / ePaces and knows how to utilize these systems to confirm enrollment eligibility. This individual is responsible for assisting in the oversight and maintenance of all logs & reports associated with Entitlement, which delineate productivity, timeframes, and quality of HomeFirst Enrollment's Entitlement processes and outcomes. Entitlement Coordinator adheres to all HIPPA standards and confidentiality requirements and is responsible for problem solving as new duties arise and volumes fluctuate.
Qualifications
- High School Diploma or equivalent, required; Associate's Degree, preferred
- Minimum of (2) years' experience in a health related field or commensurate experience in Managed Care with a concentration in Medicaid/Medicare eligibility, preferably with the geriatric population
- Familiarity with Medicaid/Medicare concepts, procedures, and enrollment practices, preferred
Min
USD $42,400.61/Yr.
Max
USD $53,000.76/Yr.
