Managed Care Outreach Specialist (Coordinating Manager - Level A), Managed Care Administration

Empower Every New Yorker - Without Exception - to Live the Healthiest Life Possible

NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city's five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Job Description
• Responsible for understanding the basic concepts, features, benefits of various managed care products including but not limited to HARP and Complete Care
• Participates in outbound calling of unique patient populations to help facilitate enrollment in various Managed Long-Term Care (MLTC) and Medicaid Advantage Plus (MAP) products to better meet their health needs
• Assists patients with services in their preferred language through the use of Interpreter Services
• Completion of referral enrollment forms and required documents (such as NYIA forms) to enrollment in various MLTC and MAP products
o Liaison with health plans and facilities to coordinate this process
• Assist in the development, implementation and improvement of value-based initiatives impacting NYC H+H risk pool members including, but not limited to, HARP and Complete Care enrollment
• Develop and maintain excellent rapport, communications, and collaborations with stakeholders across H+H facilities.
• May analyze patient records to determine eligibility for managed care products
• Plans, develops, and may conduct training programs related to managed care products
• Maintain monthly eligibility sheets and post updates to Sharepoint
• Work with IT and stakeholders to maintain SharePoint sites and provide access to facilities as needed
• Communicate with patients in a caring, empathic, and culturally competent manner
• Track results of outreach calls made to patients
• Operates with a high degree of independence
• Other duties as assigned

Minimum Qualifications
1. A Baccalaureate Degree from an accredited college or university in Public Health, Public Administration, Business Administration, Social Work, Psychology or Rehabilitation Counseling, and three (3) years of full-time experience in medically-oriented health care and medical support systems environment, two (2) years of which included experience in an administrative or supervisory capacity in such occupations as physical, occupational, inhalation, speech and audiology therapy or as Medical/Laboratory Technologist, Microbiologist (various specialties), Chemist (biochemist), Radiation and X-Ray Technician or three (3) years of responsible level experience in business management systems or general administration including two (2) years in a supervisory or administrative capacity.
2. A Masters Degree from an accredited college or university in the disciplines listed in (1), and two (2) years of full-time experience as listed in (1), plus one (1) year experience in an administrative or supervisory capacity in occupations as listed in (1); or,
3. A satisfactory equivalent combination of training, education and experience.

Note: Certification or licensure may be required.

If applying online, please include your cover letter in the same file attachment with your uploaded resume.

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Loan Forgiveness Programs for eligible employees
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• College tuition discounts and professional development opportunities
• Multiple employee discounts programs