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 MJHS Difference:At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.
Benefits include:
MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)
Responsibilities: Provides quality, cost-effective care to all members through the direct supervision of staff responsible for the management and coordination of the member's care through the incorporation of interdisciplinary strategies, medicare regulations, and medically accepted standards of care. Supervises the assessment of all acute and sub-acute inpatient care for appropriateness of setting and services, according to pre-established criteria and guidelines and ensure a 95% compliance or greater. Supervises the assessment and coordination of the members physical, psychosocial and discharge planning needs through communication with appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners. Assures appropriate staffing to support departmental/agency services. Ensures all employees are oriented to their department/agency and job and provided with appropriate training, development and continuing education. Correctly interprets and applies all Human Resources policies and procedures relative to discipline, recruitment and selection, performance appraisals, salary reviews and staffing. Qualifications: Bachelor's Degree in Nursing. Minimum one to three years previous management experience preferred. Previous managed care experience in the areas of utilization management and/or case management required. Working knowledge of Windows, Word, Excel. Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies. Min: USD $101,503.41/Yr. Max: USD $126,879.27/Yr.