Advanced Search
Title
Company
Description

Location:

Brooklyn, NY

Focus Search:

mltc
grievance and appeals
mco
direct staff
clinical director
prior authorization
state department
utilization review
care coordination
physician assistant
care management
licensed practical nurse
the health plan
intake
special needs
mba
team leader
behavioral health
hygiene
training and development
Relevance
  • Last Updated
  • Relevance
  • Urgently Hiring
All Jobs
  • All Jobs
  • Active
Within 25 miles
  • Exact location
  • Within 5 miles
  • Within 10 miles
  • Within 25 miles
  • Within 50 miles
  • Within 75 miles
  • Within 100 miles
  • Within 200 miles
35 Jobs
MetroPlus Health Plan: Director, Compliance - Medical Management Business Process Monitoring
MetroPlus Health PlanNew York, NY
Provide oversight of the development and review of the Utilization Management letter templates to ensure compliance with regulatory requirements.
Full-time
Director of Utilization Management
MetroPlus Health PlanNew York, NY
The Director of UM is responsible for collaboratively enhancing MetroPlus' utilization management capabilities and execution through the development of strong management relationships with other areas within, and outside, the Medical Management Department, including but not limited to Customer Services, MedicareOperations, Exchange Operations, Claims, Compliance, MIS, Finance, and Regulatory Affairs.
jobsearcher.com/articlesUtilization Management Job Description
To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare.
This is a new position in our Northwest Network, it will have split Care Management and UR duties.
MetroPlus Health Plan: Director, Compliance - Medical Management Business Process Monitoring
MetroPlus Health PlanTownship Of Irvington, NJ
Provide oversight of the development and review of the Utilization Management letter templates to ensure compliance with regulatory requirements.
UM Team Leader
Metroplus Health Plan IncNew York, NY
Position Overview The UM Team Leader, under the direction of the Senior Director of Clinical Services provides oversight of the administration of departmental utilization management activities.
Full-time
Utilization Review Nurse Team Leader
MetroPlus Health PlanNew York, NY
Position OverviewThe UM Team Leader, under the direction of the Senior Director of Clinical Services provides oversight of the administration of departmental utilization management activities.
$150 - $200 Full-time
Director of Behavioral Health
MetroPlus Health PlanNew York, NY
Position Overview Under the supervision of the Senior Director of Behavioral Health/HARP, the Director of BH Utilization Management is responsible for operational oversight and performance of Intake, Prior Authorization, Utilization Review practices and correspondence to ensure compliance with regulatory and contractual requirements.
jobsearcher.com/blog
How to Get a Union Job? A Step-by-Step Guide

A union job can significantly impact your job security, pay, and employment benefits. Whether this is your first job or you have years of experience, a union job can offer much-needed protection in a labor market where employees are hired and fired at will. 

MetroPlus Health Plan: Director of Mltc Clinical Program
MetroPlus Health PlanNew York, NY
Position Overview The Director of MLTC Clinical Program oversees the administration of utilization management and care management activities, including care delivered in alternate care settings for members enrolled in MLTC program offered by MetroPlus Health Plan. The manager provides assistance in the administration of departmental activities and is responsible for the administration of operations and associated staff.
Full-time
Director of Behavioral Health (BH) Utilization Management
Metroplus Health PlanNew York, NY
Position Overview Under the supervision of the Senior Director of Behavioral Health/HARP, the Director of BH Utilization Management is responsible for operational oversight and performance of Intake, Prior Authorization, Utilization Review practices and correspondence to ensure compliance with regulatory and contractual requirements.
Director of Utilization Management Appeals
MetroPlus Health PlanNew York, NY
The Director of UM Appeals is responsible for collaboratively enhancing MetroPlus' utilization management capabilities and execution through the development of strong management relationships with other areas within, and outside, the Medical Management Department, including but not limited to Customer Services, Medicare Operations, Exchange Operations, Claims, Compliance, MIS, Finance, and Regulatory Affairs.
Full-time
UM Team Leader
MetroPlus Health PlanBrooklyn, NY
Position OverviewThe UM Team Leader, under the direction of the Senior Director of Clinical Services provides oversight of the administration of departmental utilization management activities.
jobsearcher.com/blog
How to Write a Statement of Interest the Best Way

Your life's goal is to work for Company A. Their brand, their product, their reputation—it's safe to say you're a fan. The only problem is that their careers page never highlights the role that matches your skills and experience. It's a bummer for sure, but don't fret.

Director of Behavioral Health (BH) Utilization Management
MetroPlus Health PlanNew York, NY
Position Overview Under the supervision of the Senior Director of Behavioral Health/HARP, the Director of BH Utilization Management is responsible for operational oversight and performance of Intake, Prior Authorization, Utilization Review practices and correspondence to ensure compliance with regulatory and contractual requirements.
MetroPlus Health Plan: Um Team Leader
MetroPlus Health PlanNew York, NY
Position OverviewThe UM Team Leader, under the direction of the Senior Director of Clinical Services provides oversight of the administration of departmental utilization management activities.
Full-time
MetroPlus Health Plan: Director, Compliance - Medical Management Business Process Monitoring
MetroPlus Health PlanKearny, NJ
Provide oversight of the development and review of the Utilization Management letter templates to ensure compliance with regulatory requirements.
Full-time
Utilization Management Team Leader
MetroPlus Health PlanNew York, NY
For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life Position Overview The Team Leader, under the direction of the Senior Director of Clinical Services providers oversight of the administration of departmental utilization management case/disease management activities.
$100,000 - $118,896 Full-time
jobsearcher.com/blog
How to Decide Between Two Job Offers: 10 Practical Tips

It’s arguably a good predicament to have. You’ve applied to many jobs, interviewed multiple times, and now find yourself with two legit job offers. Nice! But although this is a feel-good validation of everything you have to offer, a daunting choice lies ahead. How do you decide which job will be the best fit for you?

UM Clinical Team Lead
Metroplus Health Plan IncNew York, NY
Position Overview The UM Team Leader, under the direction of the Senior Director of Clinical Services provides oversight of the administration of departmental utilization management activities.
Full-time

utilization management doh jobs Company: metroplus health plan in Brooklyn, NY

Latest Blog Posts:

jobsearcher.com/blogStructured vs Unstructured InterviewsThe goal of an interview is to evaluate candidates based on their skills, personality, and knowledge. You want to choose the BEST candidate from your candidate pool, so the interview is something you can't mess up. As you begin planning your interview process, one of the major decisions you'll face is whether the interview should be a structured vs unstructured interview. So let's take a dive into the differences and sort out which circumstances warrant which interview process.
jobsearcher.com/blogHow to Describe Your Personality with ExamplesImagine you’re in an elevator with the CEO of your dream company and you get to talking. The conversation is going well and you start to imagine yourself working for their company when the CEO turns around and asks you “tell me a bit about yourself.” Would this catch you off guard or would you be able to give a clear and succinct description of who you are?  
jobsearcher.com/blog4 Ways to Make Your Job Posting More InclusiveAccording to a Glassdoor survey,
jobsearcher.com/blogHow to Calculate Net IncomeUnderstanding your finances can be daunting even if you’re good with numbers. Your net income, in particular, is a key metric for determining how well you’re doing financially and whether your current way of operating is sustainable or not.
jobsearcher.com/blogTo ATS or not to ATSAs hiring is becoming more analytical and data-driven, companies have found ways to incorporate technology to help hire and recruit more efficiently. ATS, also known as an applicant tracking system, has become one of the most widely adopted technological recruiting tools to date. In fact, according to data from Capterra:
jobsearcher.com/blog6 Best Ways to End a Cover Letter with ExamplesIncluding a cover letter with your resume is a great way to introduce yourself to the hiring manager, tell them why you’re the ideal fit for the role, and provide context about your personal situation. A strong cover letter will give you an advantage over other applicants. But it’s important that you structure it properly and write it powerfully so that it carries an impact. This article will discuss how to end a cover letter effectively so you catch the eye of a hiring manager and increase your odds of landing an interview. Read on to learn more.
jobsearcher.com/blogHow to Write a Follow-Up Email for a Job Application?Most times, we have to do more than submit a "sugar-coated" resume to land our dream jobs. Going the extra mile to follow up on your job application can increase your chances of employment. Additionally, it may even help you get confirmation sooner on whether you are seriously being considered for the job or not.