Clinical Eligibility Specialist

20 hours ago


Farmingdale, New York, United States Centers Plan for Healthy Living Full time
Job Summary

The Clinical Eligibility Specialist is responsible for conducting comprehensive assessments to determine eligibility for the Managed Long Term Care program. This involves visiting potential members in their residences, utilizing a NYSDOH-approved assessment tool, and completing necessary documentation within established timeframes.

Key Responsibilities
  • Conduct face-to-face assessments to determine eligibility and initial plan of care
  • Complete required assessment forms and other necessary documents in a timely manner, adhering to company policies and state/federal guidelines
  • Effectively communicate plan benefits to prospects and referral sources
  • Submit thorough and high-quality documentation as needed
Requirements
  • Graduate of a 2-4 year accredited nursing program
  • Active and unrestricted NYS RN license
  • Strong written and verbal communication skills
  • Proficient in Microsoft Office Suite tools
  • Certifications/Licensure: NYS RN license

Estimated Salary Range: $92,500 - $110,000 per annum, based on location and experience.



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