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Therapist / Director of Rehabilitation Job in Newark, New Jersey

Company: All Medical Personnel, Inc.
Location: New York
Posted on: May 18, 2018

Job Description:

Specialty: Manager, GP Appeals and Grievances Resolution Location: Newark, NJ Employment: Direct Hire/Permanent - Full Time Position
Job Details
Responsible for ensuring all requirements are met regarding timeliness and resolution of complaints as mandated by CMS and regulated agencies. In addition, create and evaluate workflows/policies according to guidance and any relevant updates.Allocate work assignments to ensure daily receipts are processed in accordance with Service Level Agreements (SLAs) based on order of receipt. Review work load to identify gaps in processes and/or inefficiencies.Participate in all annual implementation projects related to Medicare Advantage- (EOCs, DSNP Implementation, MA implementation, Yearly Quality of ID cards). Participate in 3rd Level Administrative Law Judge Hearings. Lead in all external and internal departmental audits.Identify opportunities for best practices and implement process improvements (i.e., root cause analysis, technological assessments, etc.) to optimize performance and administrative cost. These improvements can be internal or cross-functional throughout the organization.Responsible for establishing, interpreting and implementing new and existing company policies and procedures based on regulations.Represents the Plan with external customers, providers and external agencies and represents the unit on corporate issues.Develop/update internal Medicare Operations training material relative to Complaint/Appeal handling.Manage, develop and train staff; develop and monitor goals; conduct annual performance reviews, and administers salaries for the staff.Requirements
Requires a bachelors degree (or higher) from an accredited college or university in a health related field.Requires five (5) years experience in Healthcare Management or related field.Requires three to five (3- 5) years of supervisory/managerial experience.Requires 5 years of Appeal/Grievance/CTM resolution.Strong leadership, decision-making, strategic problem solving, and interpersonal skills.Strong and effective communication skills, both verbal and written.Strong analytical skills; uses to validate plans and approaches.Ability to understand and interpret CMS mandates - Chapter 2 & 13.If you have any interest or would like to discuss further:
Please email CV - Bryan.Karp@palladiumsearch.comCall me at 954-239-2100Refer a colleague & earn a referral bonusAbout Us Palladium Search Partners, an All Medical Personnel company - is a national leader in healthcare staffing recognized by Staffing Industry Analysts (SIA) as one of the nation's largest healthcare staffing firms. Our clients range from local, regional and national healthcare organizations throughout the United States. Whatever the focus of your medical career, we can help you find the perfect opportunity!

Keywords: All Medical Personnel, Inc., New York, Therapist / Director of Rehabilitation Job in Newark, New Jersey, Executive, New York, New York

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