Position: Director of Utilization Management
Location: Hybrid (Must Reside in NY/NJ/CT)
Work Schedule: Monday - Friday, 9:00am - 5:00pm
Compensation: $118,135.58 - $132,902.53 Annual Salary
Join VillageCare as the Full-Time Director of Utilization Management and take the helm of a critical role in advancing patient care and operational excellence within New York's competitive health care landscape. This position offers the unique opportunity to lead a dedicated team while enjoying the flexibility of a remote work environment, allowing for a healthy work-life balance. With a salary range of $118,135.58 - $132,902.53, you will be compensated competitively for your expertise and commitment to customer-centric service. As a forward-thinking leader, you will tackle complex challenges head-on and implement innovative solutions that enhance our utilization management processes. You will be part of a high-performance culture that values integrity and excellence in all aspects of care delivery.
Embrace your chance to make a meaningful impact while working remotely in this vital position at VillageCare.
Let us introduce ourselvesVillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.
Day to day as a Director of Utilization ManagementThe Director of Utilization Management (UM) at VillageCare plays a pivotal role in overseeing the daily operations of the UM Department, encompassing critical areas such as inpatient, outpatient, and long-term support service reviews. This leadership position involves managing transitions of care and discharge planning, ensuring that outpatient services align with the VillageCareMAX benefit profile. The Director will develop and direct annual departmental programs and monitor key performance indicators to promote effective utilization management functions. Focused on delivering quality, medically appropriate care that corresponds with the severity of illness and members' benefit coverage, the role also involves innovating UM initiatives designed for cost containment and quality enhancement. Additionally, compliance with CMS Model of Care (MOC) requirements is essential.
The Director is responsible for maintaining adequate staffing levels and ensuring comprehensive training and ongoing education for both clinical and non-clinical UM personnel, thereby fostering a skilled and efficient team.
Are you the Director of Utilization Management we're looking for?To excel as the Director of Utilization Management at VillageCare, candidates must possess a robust skill set that combines leadership, analytical, and healthcare management capabilities. A minimum of five years of management experience in a health-related field, alongside three years in a quality management role, is essential for navigating the complexities of utilization management. Proficiency in analyzing data to drive improvement activities is crucial, as is a deep understanding of the regulatory structures governing quality management within Medicare and Medicaid health plans. Candidates should hold a Bachelor's Degree, with a preference for a Master's Degree, and must have an active NYS (RN) License or be willing to obtain it within three months of hire.
Strong communication and interpersonal skills are necessary for effective collaboration and to foster a culture of excellence within the team, ensuring optimal patient care and compliance with industry standards.
Knowledge and skills required for the position are:
A minimum of 5 years management experience in a health-related fieldA minimum of 3 years' experience in a quality management positionExperience analyzing and using data to drive improvement activitiesKnowledge of regulatory structure governing quality management in Medicare and Medicaid health plans.Bachelor's Degree required. Master's degree preferredActive NYS (RN) License or willing to obtain within 3 months of hire requiredYour next stepIf you believe that this position matches your requirements, applying for it is a breeze. Best of luck!
Position: HR Generalist - Benefits
Location: 120 Broadway, New York, NY 10271 - Hybrid/3 days on site (Must reside in NY/NJ/CT)
Schedule: Monday - Friday 9am-5pm
Compensation: $68,000 - $85,000 annual salary
Introduction:
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a number of Medicaid and Medicare managed care plans, and through our Assisted Living Program. VillageCare has delivered quality health care and social services to individuals residing within New York City for over 45 years
Job Summary:
The HR Generalist - Benefits is an entry-level human resource professional responsible for supporting day-to-day HR operations. This role serves as a first point of contact for routine employee inquiries and assists with core HR functions including employee onboarding, HR administration, compliance, benefits, and HR systems maintenance. The position is ideal for individuals building foundational HR knowledge while contributing to a positive employee experience. Act as the first point of contact for employee HR and benefits inquiries; resolve routine issues and escalate complex matters appropriately. Execute high-volume, transactional. HR processes with strong attention to accuracy. Follow established policies, procedures, and service level expectations
Responsibilities:
HR AdministrationEnsure accuracy and confidentiality of HR data and documentation across multiple systemsSupport processing of employee changesRespond to routine employee inquiries regarding HR policies, benefits, and proceduresEnter, update, and audit employee data in HRIS systemsRun standard HR reports and identify discrepancies for correctionManage employee inquiries and ensure timely resolutionTalent OnboardingSupport new hire onboarding processes and systemsEnsure data integrity for all employee filesAssist with new hire orientation, including benefits overviewEmployee Relations SupportProvide first-level support for employee questions and minor workplace concernsEscalate sensitive or complex employee questions or scenarios appropriatelyPromote a positive workplace culture through engagement initiativesHR Compliance & PoliciesEnsure compliance with federal, state, and local employment lawsAssist with maintaining HR policies and procedures documentationSupport audits and compliance reporting as neededBenefits & Payroll SupportAssist with benefits enrollment and respond to employee questionsCoordinate with HR Ops and payroll team to ensure accurate employee dataSupport open enrollment activities and communicationsSupport routine benefits invoice processing, including analysis, reconciliation, and submission; identify and resolve discrepanciesSupport compliance efforts related to multi-state employment practices by following established guidelines and escalating questions as neededProcess benefit enrollments, qualifying life events (QLEs), and terminations in HRIS/benefits platforms, ensuring required benefits documentation is received and organized for recordkeepingPerform data audits to ensure accuracy of benefit elections and payroll deductionsAssist with COBRA administration by coordinating eligibility data with vendorsSupport life insurance and disability claims coordinationValidate benefit deductions and partner with payroll to resolve issuesSupport retirement plan administrative tasks (e.g., loan tracking, distribution paperwork)HR Projects & ReportingParticipate in HR initiatives such as engagement surveys, training programs, and process improvementsCompile basic HR reports and metrics as requestedContribute to continuous improvement of HR processes and toolsSupport cross functional processes and special projects across HR TeamExperience:
1–3 years of HR or administrative experienceMinimum 1 year experience supporting HR BenefitsInternship experience in HR strongly preferredEducation and certification:
Bachelor's degree in Human Resources, Business Administration, or a related field, or equivalent combination of education and relevant experience.HR certification (e.g., SHRM-CP or PHR) is a plus.VillageCare is an Equal Opportunity Employer.
