Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Care Specialist - Nephrology (CKD/ESRD)

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Administrative & Support
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200QA Requisition #
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Provides confidential administrative support and assistance to the department and supports the department in all aspects of daily project operations. This includes but is not limited to answering phones, interacting with providers, authorizing cases according to standard approval process documents, documenting clinical and non clinical information to progress the utilization and/or case management process. Support members through member outreach initiatives as necessary. Send letters to members and providers as required. Maintain all regulatory timelines to support compliance with state and federal regulations.

 

Responsibilities:

·       Assist in the development of program and project plans, tracking and management of projects and departmental activities to schedule and cost.

·       Initiates correspondence; organizes meetings, conferences and seminars as necessary.  Manages internal and external correspondence and reports.  Develops and maintains centralized files and records for the department.

·      Creates, interprets, reviews, edits and organizes departmental and company audits, reports and presentations. Identifies and communicates relevant documents to the appropriate department(s).Reviews documents for accuracy, completeness and timeliness for submission to the appropriate project committees or work teams.

·       Assists in the coordination of special projects, preparations for audits.

·       Provides coverage, support and administrative duties for the department.

·       Prioritizes and presents crisis management issues to Supervisor.

·       Manages access to the department for internal and external constituents and customers.

 

Qualifications:

  • Bachelor’s Degree required; additional years of experience can be used in lieu of educational requirement.
  • Minimum 0-2 years experience in health care and/or regulatory related environment.
  • PC literate and proficiency with word processing, spreadsheets, database programs, presentation programs and good typing skills.
  • Excellent written and oral communication skills.  Administration and organizational skills. Interpersonal skills.

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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