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 staffFREE Online RN to BSN and MSN degree programs!Tuition Reimbursement for all full and part-time staffDependent Tuition Reimbursement for clinical staff!Generous paid time offAffordable medical, dental and vision coverage for employee and family membersTwo retirement plans! 403(b) AND Employer Paid PensionFlexible spendingAnd MORE!
MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)
ResponsibilitiesQuality Review Auditor (QRA) is responsible for ongoing audits of the care management staff, quality assurance, accuracy and overall integrity of the care management records and documentation. QRA will listen to the calls completed by the care management staff to identify gaps in knowledge and assess for professionalism of the staff completing the calls. This role is to ensure compliance with NYS DOH and CMS regulations through development of audit tools and validating all data collected. Quality Review Auditor will be responsible to analyze collected audit data, identify trends for staff re-training and implementing corrective action plans in collaboration with Coordinated Care Management staff. Provide support to Directors, Managers and Supervisors to ensure that all documentation and reporting requirements are prepared and maintained in a professional and well-coordinated manner.
Qualifications Graduate from an accredited School of Nursing. BSN or BS degree preferredMinimum of two (2) years of working in care management experience requiredManaged Care experience preferredLicensed to practice as Registered Professional Nurse in NYSExcellent analytical skills, interpretation of dataStrong critical thinking skillsKnowledge of Medicare and Medicaid regulationsAbility to set priorities and to handle multiple assignmentsWorking knowledge of audit techniques and methodologiesWorking knowledge of State and Federal regulationsTravels to perform business partners training Min USD $92,276.31/Yr. Max USD $115,345.38/Yr. Options Apply for this job onlineApplyShareRefer this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Application FAQsSoftware Powered by iCIMS
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