RiverSpring Living
MLTC-
Quality Coordinator - Managed Long Term Care (MLTC) - Immediate Opportunity
Join Our Team as a Quality Coordinator at RiverSpring Health Plans!
Do you have a passion for caring for older adults? If so, you've found the perfect place to advance your career! Join our compassionate and dedicated team and make a meaningful difference in the lives of our members.
RiverSpring Health Plans serves over 18,000 frail individuals and help them live in their homes and independently for as long as possible. Join our compassionate and dedicated team and make a difference in the lives of our members at RiverSpring Health Plans.
As the Quality Coordinator you will be responsible for completing the Appeal review forms, assigning cases for daily review, emailing care management teams, outside vendors etc. for notes and follow up, calling members and/or authorized representatives for appeal rationale, for follow up information, appeal decisions, compiles appeal case files, updates the appeal excel spreadsheet and daily log.
Hybrid schedule 3 days in the office 2 days at home
Key Responsibilities: Following up on assigned grievances until closure. Handles emails and calls to the quality department, triages and forwards as indicated. Qualifications:
High School Diploma, Associate Degree preferred Minimum of 1-2 years office work. Work in Quality department in a MLTC or other Managed Care organization preferred. Effective oral and written communication skills. Strong organizational skills. Good interpersonal skills. Thorough knowledge of the computer, proficiency with Microsoft Word and Excel. Ability to work and manage problems independently. Excellent customer service skills and ability to handle difficult phone conversations. Compensation:
Salary: Min. $35.3572 hourly Benefits include health insurance, retirement plans, paid time off, and professional development opportunities
If you're ready to make a significant impact in the lives of older adults and support their wound care needs, we would love to hear from you!
Equal Opportunity Employer (EOE)
Quality Coordinator - Managed Long Term Care (MLTC) - Immediate Opportunity
Join Our Team as a Quality Coordinator at RiverSpring Health Plans!
Do you have a passion for caring for older adults? If so, you've found the perfect place to advance your career! Join our compassionate and dedicated team and make a meaningful difference in the lives of our members.
RiverSpring Health Plans serves over 18,000 frail individuals and help them live in their homes and independently for as long as possible. Join our compassionate and dedicated team and make a difference in the lives of our members at RiverSpring Health Plans.
As the Quality Coordinator you will be responsible for completing the Appeal review forms, assigning cases for daily review, emailing care management teams, outside vendors etc. for notes and follow up, calling members and/or authorized representatives for appeal rationale, for follow up information, appeal decisions, compiles appeal case files, updates the appeal excel spreadsheet and daily log.
Hybrid schedule 3 days in the office 2 days at home
Key Responsibilities: Following up on assigned grievances until closure. Handles emails and calls to the quality department, triages and forwards as indicated. Qualifications:
High School Diploma, Associate Degree preferred Minimum of 1-2 years office work. Work in Quality department in a MLTC or other Managed Care organization preferred. Effective oral and written communication skills. Strong organizational skills. Good interpersonal skills. Thorough knowledge of the computer, proficiency with Microsoft Word and Excel. Ability to work and manage problems independently. Excellent customer service skills and ability to handle difficult phone conversations. Compensation:
Salary: Min. $35.3572 hourly Benefits include health insurance, retirement plans, paid time off, and professional development opportunities
If you're ready to make a significant impact in the lives of older adults and support their wound care needs, we would love to hear from you!
Equal Opportunity Employer (EOE)