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
The Manager of Clinical Business Process Monitoring leads monitoring and auditing activities of clinical business processes for internal and delegated entities. The Manager of Clinical Business Process Monitoring oversees the core functions of routine clinical monitoring and special audit/monitoring projects, the analysis of findings and presentation of those findings to internal teams and delegated vendors.
In addition, this role provides strategic proposals and careful planning to meet organizational goals, minimize regulatory risk and consider efficiencies within vendor and other special projects as assigned to meet targets and take measurable steps to achieve successful outcomes.