The Partnership Engagement Advisor manages member-level communication and health plan engagement for the Community Supports division, overseeing MCO submissions, eligibility reviews, reauthorization outreach, plan portal activity, and inbound communication to ensure members receive timely, uninterrupted non-medical caregiving services.
Compensation
$27.75—$30.87 USD
Responsibilities
Manage assigned MCO partnership workflows, including accurate same-business-day submissions, plan portal monitoring, eligibility follow-up, and communication with health plan contacts.
Lead the full reauthorization process by coordinating required documentation, member outreach, and timely extension requests in accordance with established criteria.
Monitor inbound emails, faxes, Salesforce cases, plan portals, and community referral systems; route communications to the appropriate team members and maintain timely follow-through.
Conduct member care assessments, gather and document client and family caregiver information, and coordinate with outreach teams to assess service eligibility.
Maintain accurate lead, contact, activity, and engagement records in Salesforce while partnering with Analytics, Marketing, Operations, and sales stakeholders on targeted engagement efforts.
Support all aspects of the Pharmacy Business Segments by working with the Pharmacy Department to provide hands-on support, consultation, technical and operational expertise.
Compensation
$79,100.00 - $104,800.00 - $130,500.00 Annual
Responsibilities
Support the Pharmacy Business Segments (Self Insured, Fully Insured, and Government Programs), by providing pharmacy technician expertise across clinical, administrative, and operational activities.
Conduct and analyze pharmacy utilization reports from business database applications, and validate the data for accuracy and consistency.
Engage and collaborate with internal and external business teams in the business planning process.
Evaluate and document all current processes and procedures of pharmacy partners.
Develop workflows/processes, identify gaps and opportunities for improvement of standard operating procedures, support implementation, and drive continuous improvement in process efficiency and data integrity.
Supports clinical and operational formulary needs across multiple lines of business, evaluates new drugs, develops recommendations, and maintains formularies and related publications.
Compensation
Potential pay for this position ranges from $108,000.00 - $184,000.00 based on experience and skills.
Responsibilities
Manage formularies and clinical criteria for claims adjudication, prescription drug lists, websites, and related publications
Participate in clinical and financial drug review committees; perform drug and class reviews and develop recommendations
Research and explain clinical and business considerations related to drugs, drug classes, and formulary strategies
Monitor weekly drug files for new products and apply appropriate drug statuses and formulary placement
Perform routine formulary quality reviews using available reports and pharmacy data
Requirements
PharmD or Bachelor of Science Pharmacy degree
Nice to have: experience with health plan, PBM, Managed Medicaid, formulary operations, drug review committees, or utilization management
Nice to have: experience with formulary adjudication, clinical criteria implementation, prescription drug list publishing, or pharmacy data analysis
Nice to have: experience with Microsoft Visio or Access
Provide one‑on‑one support to individuals who self‑direct their care, assisting with daily living, mobility, meals, housekeeping, community engagement, and health plan tasks.
Responsibilities
Assist with personal care needs such as bathing, dressing, grooming, and toileting
Support mobility, transfers, and safe movement
Help with meals, eating, and maintaining safety
Assist with light housekeeping and maintaining a safe home environment
Support daily routines and independent living skills
Provide one‑on‑one support to individuals who self‑direct their care, assisting with daily living, personal care, mobility, meals, housekeeping, community engagement, and health plan tasks.
Responsibilities
Assist with personal care needs such as bathing, dressing, grooming, and toileting
Support mobility, transfers, and safe movement
Help with meals, eating, and maintaining safety
Assist with light housekeeping and maintaining a safe home environment
Support daily routines and independent living skills
Membership Consultants are the primary evangelists of ArchWell Health and grow our patient base in the communities we serve. As outside healthcare sales professionals, they ensure all seniors who can benefit from excellent medical care are reached, inspired, and aided in joining our medical centers.
Responsibilities
Drives new patient enrollment year-round by identifying, cultivating, and securing new patients through direct-to-consumer, business-to-business, and community stakeholder relationships
Meets individual seniors and groups in their homes, senior centers, houses of worship, and other community gathering places to evangelize the ArchWell Health mission & value proposition for seniors
Plans, coordinates, and executes local events in the community and in our centers to help reach our ideal patients (e.g. medically underserved, Medicare-eligible seniors)
Cultivates relationships with individual health plan agents, independent brokers, social workers, case workers, senior housing managers, senior centers, and related community providers to position ArchWell Health as their preferred provider for senior healthcare when referring or assigning patients to a primary care physician
Partners with ArchWell Health Community Relations on initiatives with community officials/influencers, businesses, and public health programs that appropriately drive new patient growth
Membership Consultants are the primary evangelists of ArchWell Health and grow our patient base in the communities we serve.
Responsibilities
Drives new patient enrollment year-round by identifying, cultivating, and securing new patients through direct-to-consumer, business-to-business, and community stakeholder relationships
Meets individual seniors and groups in their homes, senior centers, houses of worship, and other community gathering places to evangelize the ArchWell Health mission & value proposition for seniors
Plans, coordinates, and executes local events in the community and in our centers to help reach our ideal patients (e.g. medically underserved, Medicare-eligible seniors)
Cultivates relationships with individual health plan agents, independent brokers, social workers, case workers, senior housing managers, senior centers, and related community providers to position ArchWell Health as their preferred provider for senior healthcare when referring or assigning patients to a primary care physician
Partners with ArchWell Health Community Relations on initiatives with community officials/influencers, businesses, and public health programs that appropriately drive new patient growth
Requirements
H.S. Diploma or GED required; Bachelor’s degree is helpful
Nice to have: Experience with a health plan, FMO / benefits broker, or provider
Nice to have: Experience working with or selling to the senior community or medically underserved
The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $65,885.00 - $106,891.29 Annually.
Responsibilities
Provides operational oversight to discharge planning team to ensure that all day to day activity supports optimum patient throughput and excellent patient care.
Attends and participates in meetings with senior leadership to strategize, present data and implement process improvement around length of stay and excess days.
Manages successful discharge planning process and facilitates discharge plans, which is critical to LOS reduction and patient flow.
Responsible for managing resources, rapidly responds to requests by Case Management, Social Work, and Unit Staff and offers insight when needed.
Maintains contact with the unit case manager and social worker in respect to timely provision of documentation and patient choice and accepting facility.
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