Hamaspik Choice, Inc. is seeking to hire for full time in-office positions within the Care Management...Read more
Hamaspik Choice, seeking a qualified individual to join our Care Management Department, as Director of Care Management..Read more
Hamaspik Choice, seeking a qualified individual to join our Quality Assurance Department, as Director of Quality Assurance..Read more
Hamaspik Choice, seeking a qualified individual to join our Network Development Department, as Network Development specialist..Read more
Hamaspik Choice, Inc. is seeking to hire for full time in-office positions within the Care Management Department. Candidates must be a RN and/or SW with experience in the healthcare and/ or MLTC field. This position is responsible for the care management of assigned members and collaborates with service providers, caregivers, families and members to ensure members are able to remain safely in their homes as long as possible and within the guidelines of a Managed Long Term Care Program. Candidate must be able to communicate well with professionals within and outside of the organization, as well as with potential members and their families. Familiarity with the clinical issues faced by MLTCP clients and the appropriate management of such is critical. Time management and organization skills are essential in this fast-paced environment. A passion of working with the geriatric population must be evident in all interactions. Bilingual a plus.
Hamaspik Choice, Inc. is seeking to hire a Registered Nurse for a Full time in-office position as a Care Planner in the Care Management Department. This position is responsible for the development of a person centered service plan/ plan of care based off of the assessment documentation completed by the visiting RN. Candidate must be able to make decisions that are financially prudent, highly ethical, in compliance with all governing regulations, and demonstrate a commitment to our members welfare and well-being.
Hamaspik Choice, Inc. is seeking to hire Nurse Assessors in the Hudson Valley Region. The Nurse Assessor works for the Managed Long Term Care Plan conducting initial UAS-NY assessments and reassessments to evaluate potential members for enrollment eligibility in the MLTC Plan. Clinical assessment skills are critical. Position entails collaboration with the Utilization Management team, members and family members in providing the best possible individualized care.
The Director of Care Management will lead the clinical operations of the Plan. Responsibilities include supervising staff and overseeing day to day workflow processes. Candidate works collaboratively with the leadership team supporting high quality outcomes and member satisfaction. The Director ensures timely and appropriate access of services, and that team is compliant with all regulatory requirements.
• Provides day-to-day oversight of Care Management operations, ensuring all practices and programs are aligned with the overall strategic plan of the organization.
• Sets direction for Care Management staff, ensuring accountability, quality outcomes, and follow-through.
• Provides leadership and direction to Care Management team.
• Assists Care Mangers in completing comprehensive assessment and care plans to evaluate the member's need for services.
• Plays active role in creating, applying and utilizing policies and procedures.
• Performs other duties as assigned
The ideal candidate will possess a minimum of 3- 5 years of professional experience within a Managed Care Organization.
Candidates must be a current NYS licensed RN
• Develop and implement an annual Quality Management work plan, and lead Quality Assurance initiatives including the monitoring and evaluation of the quality of all programs.
• Implement and coordinate the quality committee structure, as required by regulation.
• Lead HEDIS/QARR submissions, and lead quality improvement projects, designed to improve outcomes for enrolled members.
• Implement initiatives to conduct member satisfaction surveys.
• Develop and implement processes to monitor the quality of network providers.
• Responsible for all incident management including the investigations and corrective action plans of all incidents within the company and its providers.
• Oversee all quality related reporting requirements.
Education- BA required in healthcare, MA preferred.
Experience- 5 years' experience within a managed care plan, with experience leading Quality Assurance activities in Medicaid and Medicare health plans preferred.
Responsibilities include building and maintaining a successful working relationship between network providers to ensure a geographically broad access and stable network. Candidate will also negotiate cost effective fees, confirm service capability, respond to provider inquiries, and educate providers on contract expectations, processes and paperwork. Individual must be a quick learner, able to multi-task, and have excellent communication and organization skills.
The Compliance Analyst will assist with implementing the Compliance Program, and will conduct Compliance Monitoring activities including auditing and investigating the plan's operations to ensure compliance with all requirements. The Compliance Analyst will be responsible for overseeing continuous projects to assure operational compliance with regulations.
The position will include:
• Auditing and Monitoring of the plan's operations
• Research of regulations in collaboration with legal counsel
• Implementing updated policies and procedures
• Conducting staff trainings
• Develop internal protocol to assure compliance on multiple aspects of the plan's operations
Candidate will have:
• Regulatory experience in the Medicaid Managed Care industry
• Experience with auditing and investigating company processes
• Experience with writing, developing and implementing managed care policies and procedures
• Knowledge of MLTC requirements
The Home Care Specialist is responsible for the coordination of home care benefits which include PCA, CDPAS, HHA and skilled services to secure coverage.
Responsibility includes coordination for new members, existing members as well as ongoing communication with all home care providers.
Candidate must be able to multi-task and have excellent communication and organization skills.