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Individualized professional and personal growth is a primary focus at CPHL. With various teams to match the unique strengths of each individual, tiered roles to support the advancement, and with opportunities for cross-training and education, CPHL is the place for a fulfilling long-term career.JOB SUMMARY: Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims. Collaborates with other Health plan departments and Management to ensure claims are processed in ac ...Read more about Claims AuditorMore
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5297 W Copans Rd, Margate, FL 33063, USA ● Req #11982Friday, June 7, 2024Business Development Liaison The Business Development Liaison acts as the intermediary between other departments and the Business Development team regarding any referral. Duties and Responsibilities Manages communications between account managers, intake staff, and referral sources. Responds to inquiries from account management team quickly and efficiently. Contributes to the management of the organization’s referrals by ensuring tasks are completed accurately and timely. Makes calls to d ...Read more about Business Development LiaisonMore
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75 Vanderbilt Ave, Staten Island, NY 10304, USA ● Req #660Wednesday, June 5, 2024JOB SUMMARY: As an integral part of the Grievance and Appeals (G&A) Department, the G&A Coordinator lends their support in processing member-related grievances and appeals across CPHL’s various lines of business. Process includes gathering, documenting, tracking, and pursuing resolution of complaints in accordance with regulatory and organizational guidelines to the member’s satisfaction. PRIMARY RESPONSIBILITIES: Logs and tracks verbal or written member grievances and ...Read more about Grievance and Appeals CoordinatorMore
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Our NP CHAMPIONS advocate to improve the health and quality of life of our nursing home residents. Their goal is to create the ultimate healthcare experience that provides members, families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living. JOB SUMMARY: The nurse practitioner treats acute and chronic conditions in place while maintaining the highest level of daily function possible. Scope of responsibilities include building connec ...Read more about Nurse Practitioner - ISNP (Full-Time & Part-Time)More
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75 Vanderbilt Ave, Staten Island, NY 10304, USA ● Req #266Monday, June 3, 2024JOB SUMMARY: The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, maintains relationships, services our existing customers and secures new customers by consultative selling/marketing and performing all required tasks assigned by the Sales Field Manager. Incumbent will be responsible for educating and enrolling potential beneficiaries by explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company poli ...Read more about Medicare MAP AdvisorMore
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Bronx, NY, USA ● Brooklyn, NY, USA ● Manhattan, New York, NY, USA ● Queens, NY, USA ● Staten Island, NY, USA ● Req #333Monday, June 3, 2024JOB SUMMARY: The Licensed Benefits Advisor- Medicare Sales, Maintains relationships, services our existing customers and secures new customers by consultative selling/marketing and performing all required tasks assigned by the Sales Manager. Incumbent will be responsible for educating and enrolling potential beneficiaries by explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and regulations. The Licensed Benefits ...Read more about Licensed Benefits Advisor (Field Based)More
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JOB SUMMARY: The nurse practitioner treats acute and chronic conditions in place while maintaining the highest level of daily function possible for CPDL members. Scope of responsibilities include building connections with members, designated representative and the interdisciplinary care team (ICT) through assessing needs, creating individualized care plans, coordination of care to ensure smooth transitions across settings. PRIMARY RESPONSIBILITIES: Provide proactive primary and acute ...Read more about Nurse Practitioner - ISNP (Full-Time)More
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5297 W Copans Rd, Margate, FL 33063, USA ● Req #375Monday, June 3, 2024SUMMARY: The Transition of Care Specialist is responsible to assist in a safe and effective discharge of members from the hospital setting to the community. The Specialist serves as a bridge between professional staff in the care setting (i.e. hospital, physician, social worker and nurse). The Transition of Care Specialist provides information and guidance and care coordination for effective care transition from hospital to community. DUTIES AND RESPONSIBITIES: Conducts telephonic assessmen ...Read more about Transition of Care SpecialistMore
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Rockland County, NY, USA ● Req #384Monday, June 3, 2024Field Nurse RN (New Grad & Experienced) - Rockland County (Full-Time and Fee-for-Service) Come join our team of dedicated professionals. Take your career in a new direction. We are currently accepting applications for compassionate, motivated Full Time, and Fee for Service, EXPERIENED & NEW GRADUATE REGISTERED NURSES for our CHAA division. We strive to provide QUALITY services to our patients. Reporting to the Coordinator Of Care (COC), the Field RN assesses, plans and coordinates home care ser ...Read more about Field RN (Rockland County) - Full-Time and Fee-for-ServiceMore
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Field Nurse RN (New Grad & Experienced) - Westchester County Come join our team of dedicated professionals. Take your career in a new direction. We are currently accepting applications for compassionate, motivated Full Time, and Fee for Service, EXPERIENED & NEW GRADUATE REGISTERED NURSES for our CHAA division. We strive to provide QUALITY services to our patients. Reporting to the Coordinator Of Care (COC), the Field RN assesses, plans and coordinates home care services for assigned patient ca ...Read more about Field RN (Westchester County)More
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Come join our team of dedicated professionals. Take your career in a new direction. We are currently accepting applications for compassionate, motivated Full Time, EXPERIENCED & NEW GRADUATE REGISTERED NURSES for our CHAA division. We strive to provide QUALITY services to our patients. The RN Coordinator of Care (COC), responsible for organizing and directing home care services to patients. Ensures appropriate coordination among all professional and paraprofessional services related to the car ...Read more about Registered Nurse - New Grads/Entry Level WelcomeMore
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Field Nurse RN (New Grad & Experienced) - Nassau County Come join our team of dedicated professionals. Take your career in a new direction. We are currently accepting applications for compassionate, motivated Full Time, and Fee for Service, EXPERIENED & NEW GRADUATE REGISTERED NURSES for our CHAA division. We strive to provide QUALITY services to our patients. Reporting to the Coordinator Of Care (COC), the Field RN assesses, plans and coordinates home care services for assigned patient caseloa ...Read more about Field RN (Nassau County)More
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Field Nurse RN (New Grad & Experienced) - Suffolk County Come join our team of dedicated professionals. Take your career in a new direction. We are currently accepting applications for compassionate, motivated Full Time, and Fee for Service, EXPERIENED & NEW GRADUATE REGISTERED NURSES for our CHAA division. We strive to provide QUALITY services to our patients. Reporting to the Coordinator Of Care (COC), the Field RN assesses, plans and coordinates home care services for assigned patient caselo ...Read more about Field RN (Suffolk County)More
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Bronx, NY, USA ● Brooklyn, NY, USA ● Long Island, New York, USA ● Manhattan, New York, NY, USA ● Queens, NY, USA ● Staten Island, NY, USA ● Req #455Monday, June 3, 2024FEE FOR SERVICE - FIELD HOMECARE RN (All Five Boroughs) Come join our team of dedicated professionals. Take your career in a new direction. We are currently accepting applications for compassionate, motivated EXPERIENED REGISTERED NURSES for our CHHA division. We strive to provide QUALITY services to our patients. Duties and Responsibilities The Field RN (Registered Nurse) performs home visits, assessments and follow up visits to patients. The RN advocates for quality patient care, collabor ...Read more about Fee for Service - Field Homecare RN (All Five Boroughs)More
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Clinical ManagerResponsible for assuring the delivery of quality health care services to the patient. The Clinical Manager represents the agency by facilitating its mission and agency objectives. Duties and Responsibilities Utilizes current nursing concepts and principles as well as understanding of coverage criteria to direct, supervise and ensure the quality of care provided by the Coordinators of Care (COC) and other Clinical staff Assures the periodic reassessment of and appropriate r ...Read more about RN Clinical ManagerMore
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Job Summary: We are currently looking for Clinical Review RN’s to join our team. These positions are responsible for the review of the admission, resumption, recert and discharge assessments for Medicare, Medicaid, Medicare/Medicaid HMO cases to ensure diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Responsibilities Include: Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in complia ...Read more about Clinical Review RNMore
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5297 W Copans Rd, Margate, FL 33063, USA ● Req #461Monday, June 3, 2024JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial Adverse Determinations or Organization Determinations that have been appealed. The Clinical Reviewer will handle expedited and standard requests and ensures that the appeals are processed in accordance with regulations, compliance standards and policy and procedures. Investigation and preparation of case narratives and statements of position based on clinical information, benefits, ...Read more about RN - Grievance and Appeals Clinical ReviewerMore
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LPN We're expanding our footprint and seeking Full Time LPNs to join our Margate, Florida team. Duties and Responsibilities Implements plan of care initiated by the registered nurse. Provides accurate and timely documentation consistent with the plan of care. Assesses and provides patient and family/caregiver education and information pertinent to diagnosis and plan of care. Informs Team Lead of issues pertinent to the care plan process and any known or perceived issues. Participates in coordin ...Read more about LPN - Office BasedMore
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Bronx, NY, USA ● Brooklyn, NY, USA ● Manhattan, New York, NY, USA ● Queens, NY, USA ● Staten Island, NY, USA ● Req #487Monday, June 3, 2024Licensed Practical Nurse (LPN) Certified Home Health Agency Perform under the direction of a Registered Nurse in following the Plan of Care for individual clients. Competent in assessing client physical and psychosocial status changes and reporting findings to the Registered Nurse. JOB DUTIES/KNOWLEDGE Provides skilled nursing to clients including, but not limited to treatment, medication administration, and treatment as directed by Registered Nurse and the Physician’s Plan of care in ac ...Read more about Licensed Practical Nurse (All boroughs)More
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Bronx, NY, USA ● Brooklyn, NY, USA ● Manhattan, New York, NY, USA ● Queens, NY, USA ● Staten Island, NY, USA ● Req #490Monday, June 3, 2024Speech Language PathologistCenters Plan for Healthy Living is expanding its footprint and we are seeking Speech Therapist to provide home-based speech therapy services. Responsibilities: Make home visits to clients. Evaluates patients referred for home care services to determine appropriateness for speech therapy services. Establishes a home care plan including assessment of the appropriateness of the requested services. Provides rehabilitative services for speech and lang ...Read more about Homecare Speech Pathologist (All boroughs - Field Based)More
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Brooklyn, NY, USA ● Req #491Monday, June 3, 2024Speech Language PathologistCenters Plan for Healthy Living is expanding its footprint and we are seeking Speech Therapist to provide home-based speech therapy services. Responsibilities: Make home visits to clients. Evaluates patients referred for home care services to determine appropriateness for speech therapy services. Establishes a home care plan including assessment of the appropriateness of the requested services. Provides rehabilitative services for speech and lang ...Read more about Homecare Speech Pathologist - Fee for Service (Brooklyn - Field Based)More
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Primary Responsibilities: Provides case management through telephonic assessments, care planning, implementation, care coordination, monitoring and evaluation to ensure member receives services and supports required to meet psychosocial, educational and health care needs Develops, facilitates, and communicates a plan of care in partnership with the member, his/her significant other, primary caregiver, the primary and attending physicians, and various other providers involved in the member’s ...Read more about RN Care Manager (Hybrid)More
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JOB SUMMARY: Establishes new and maintains existing relationships with key community organizations and leaders, including but not limited to Community Based Organizations (CBOs), FBO’s, political leaders, advocacy groups, and the provider community. Educates consumers in the communities served by CPHL about Medicare Advantage Special Needs Plans and the benefits of enrolling in the CPHL CHOICE Special Needs Plan. Achieves monthly enrollment requirements and attends and conducts presenta ...Read more about Account LiasionMore
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Come join our team of dedicated professionals. Take your career in a new direction. We are currently accepting applications for compassionate, motivated Full Time, EXPERIENCED & NEW GRADUATE REGISTERED NURSES for our CHAA division. We strive to provide QUALITY services to our patients. The RN Coordinator of Care (COC), responsible for organizing and directing home care services to patients. Ensures appropriate coordination among all professional and paraprofessional services related to the ca ...Read more about Registered NurseMore
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Manhattan, New York, NY, USA ● Req #629Monday, June 3, 2024We are expanding our foot print and seeking compassionate Physical Therapist to provide home-based physical therapy services. Our Therapist contribute to improving mobility and enhancing the quality of life to our members. Physical Therapist Responsibilities: Travel to and from patients' homes, providing physical therapy as ordered by a physician in accordance with the designated plan of care. Design treatment plans that achieve results through personalized, 1-on-1 individualized care. Evalua ...Read more about Homecare Physical Therapist - Per-Diem and Full Time (Manhattan - Field Based)More