Healthfirst Temporary - Clinical Correspondence Writer/Editor (Telecommuter) in New York, New York

Description

The Temporary Clinical Correspondence Writer/Editor is responsible for completing a concurrent quality review of determination and patient centered service plan letters across all of Healthfirst's products.

Duties and Responsibilities:

  • Performs daily reviews of manual letters produced from CCMS , Trucare, Inspire, and PCSP Sharepoint to members and providers to ensure adherence to Article 44 and 49 of the NY State Public Health Law and Appendix F, Medicare Managed Care Manual Chapter 13 and commercial contracts and others as necessary.

  • Ensures compliance with Healthfirst’s corporate branding requirements.

  • Conducts quality checks of CCMS and Trucare event while reviewing letters to ensure compliance to all managed care regulations while identifying and documenting areas of non-compliance.

  • Participates in the corporate-wide letter management improvement program and function as one of the department's participants in writing/editing member and provider letters for the Care Management department.

  • Assists with the creation, storage, protection, retrieval and retirement of letters to enrollees, providers and facilities from company systems.

  • Additional duties as assigned.

Minimum Qualifications:

• HS diploma or GED

Preferred Qualifications:

• Bachelor's degree in related allied health care field such as nursing or social work

• Basic knowledge MS SharePoint preferred.

• Regularly uses moderately complex oral and written skills. May train others in functional areas and interact with others across Healthfirst and/or externally.

• Work experience in healthcare

• Experience with government programs and managed care, including but not limited to, processing organizational determinations- approvals and denials, or appeals and grievance type of events.

License or Certification: n/a

Regulatory or Compliance activities: n/a

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement

REQNUMBER: R002908