cablevision Jobs

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Education Manager, Medical Management

Healthfirst - Telecommuter

Responsibilities: Oversees the training of new hire staff related to the provision of the basic departmental functions which include: pre-certification, concurrent review, discharge planning, case management, disease management, appeals processing and referrals, Healthfirst and SHP standards and the rules/regulations set forth by the Company, the Department of Health and state and fed...

Application Deadline: None

Registered Nurse, Medical Management - Regulatory

Healthfirst - Telecommuter

Responsibilities: Meets with Regulatory to organize pre-survey deliverables and conducts pre-survey reviews of materials. Interacts with and represents the Medical Management department and external auditors. Responds to auditor requests and audits outcome results. Prepares and coordinates on-site and electronic audits conducted by external regulatory entities. Coordinates ...

Application Deadline: None

Social Worker- Welcome Team

Healthfirst - Telecommuter

Responsibilities: Uses all available resources to assess members' psychosocial health status and social work needs; this includes making field home visits as needed in order to complete a psychosocial assessment for all new members within the first 30 days of enrollment. Determines member and family needs to develop a comprehensive care plan for each member based on counsel...

Application Deadline: None

Nurse Care Manager, Complete Care

Healthfirst - Telecommuter

Responsibilities: Contributes to the development of patient-focused care and initiates the process in accordance with established guidelines. Conducts assessments, develops treatment plans, performs defined interventions, and generates referrals to providers, community-based resources and appropriate social services. Assesses member's physical, psychosocial and d...

Application Deadline: None

Clinical Quality Assurance Auditor LPN

Healthfirst - New York, NY

Responsibilities: Review clinical eligibility documentation guaranteeing outlined components of the Member's medical record are complete and accurate following state regulations and company policies. Analyze various types of data and processes in a versatile manner and present findings and recommendations. Identify defects and improve departmental performance by supporting ...

Application Deadline: None

Nurse Care Manager - SHP

Healthfirst - Telecommuter

Responsibilities: Maintains ongoing telephonic communication with members and their caregivers to ensure a safe and appropriate care plan. Member family education re: health management and community resources. Appropriately manages member care including but not limited to; coordination of benefits (Medicare Medicaid), coordinating monitoring all skilled services,...

Application Deadline: None

Social Worker -SHP

Healthfirst - Telecommuter

Responsibilities: Uses all available resources to assess members' psychosocial health status and social work needs; this includes making field home visits as needed in order to complete a psychosocial assessment for all new members within the first 30 days of enrollment. Determines member and family needs to develop a comprehensive care plan for each member based on counsel...

Application Deadline: None