Business Process Monitoring Coordinator

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

MetroPlusHealthis committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

Under the supervision of the Manager of Clinical Business Process Monitoring (BPM), the Business Process Monitoring Coordinator will be responsible for compiling and reviewing monitoring reports and monitoring dashboards to ensure compliance. They will support internal and delegated vendor oversight activities and assist in ensuring corrective actions are well documented and archived as well as compiling monthly and quarterly reporting of monitoring and auditing activities.

The role requires the candidate to assist in compiling department monthly and quarterly reporting and therefore must be highly organized with an exceptional attention to detail and accuracy. The Business Process Monitoring Coordinator will also be responsible for ad hoc projects aimed at ensuring the organization's overall compliance. The Business Process Monitoring Coordinator will also maintain a collaborative relationship with allied departments within the company, working closely with Regulatory Affairs and Compliance on regulatory changes impacting MetroPlusHealth and monitor specific operational areas to improve operational efficiencies.

The Business Process Monitoring Coordinator will work closely with the MetroPlusHealth departmental subject matter experts to ensure the delegates comply with regulatory and contractual requirements.

• Conducts a compliance review of monthly and quarterly data tables to detect issues of non-compliance.
• Assists in compiling monthly and quarterly dashboard reports for Compliance division leadership and company senior management.
• Follows department workflows to compete compliance review of case files requested documentation has been included in the case files.
• Creates, reviews, and submits internal tracking mechanisms for productivity and accountability purposes.
• Ensures accurate tracking of audit and monitoring activities including but not limited to updating trackers and audit and monitoring databases.
• Plays a key role in assisting in preparing documentation for external audits and reviews.
• Participates in business area on-site and/or desk-top audits and/or schedules ad hoc on-site meetings as required, to address specific compliance issues or support implementation of new policies and regulations.
• Participates in joint operating committee meetings with other MetroPlusHealth business owners and delegated vendors.
• Participates in meetings with delegates to provide performance metrics feedback.
• Assists co-workers and other staff as directed.
• Other duties as assigned or requested.

• Associate's degree required; and
• 4 years' healthcare experience required; or
• A satisfactory equivalent combination of education, training, and experience.
• Bachelor's degree preferred.
• Experience in a Managed Care setting in Utilization Management, Case Management or Quality Management preferred.
• Working knowledge/experience in Microsoft Office Suite (Excel, MS Teams, SharePoint, Power BI).

Professional Competencies

• Strong written and verbal communication and presentation skills
• Results driven and detailed oriented.
• Ability to work independently in a fast-paced environment with changing priorities.
• Strong interpersonal and human relations skills and ability to establish and maintain strong positive working relationships.
• Ability to learn new software to conduct documents and file review

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