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Quality Coordinator - Managed Long Term Care (MLTC)

Quality Coordinator - Managed Long Term Care (MLTC)

Pride HealthNew York, NY, US
20 hours ago
Job type
  • Full-time
Job description

Job Description

Job Title : Quality Coordinator – Managed Long Term Care (MLTC)

Location : Bronx, NY (Hybrid : 3 days in office, 2 days remote)

Job Type : Full-Time

We are seeking a Quality Coordinator to join our Managed Long-Term Care (MLTC) team. This role is ideal for someone who is passionate about helping older adults maintain their independence while ensuring quality standards are met. You will play a key part in supporting appeals, grievances, and quality-related processes that directly impact member care and satisfaction.

Key Responsibilities :

  • Complete appeal reviews forms and assign cases for daily review.
  • Communicate with care management teams, outside vendors, and members / authorized representatives regarding appeals and grievances.
  • Compile appeal case files, maintain accurate logs and Excel spreadsheets, and ensure timely updates.
  • Follow up on assigned grievances until closure.
  • Manage incoming emails and calls to the quality department, triage, and route appropriately.

Qualifications :

  • High School Diploma required; Associate degree preferred.
  • 1–2 years of office experience (experience in MLTC or other managed care organizations preferred).
  • Strong oral and written communication skills.
  • Excellent organizational and interpersonal skills.
  • Proficiency in Microsoft Word and Excel.
  • Ability to work independently and manage problem-solving effectively.
  • Strong customer service skills and ability to handle challenging conversations.

    • Compensation & Benefits :

  • Competitive hourly pay : $35.36 / hour
  • Comprehensive health insurance
  • Retirement plans
  • Paid time off
  • Professional development opportunities

    • Why Join Us?

    This is more than just a job—it’s an opportunity to make a meaningful impact on the lives of older adults. You’ll join a supportive team where your contributions are valued and your growth is encouraged.

    Apply Today!

    If you’re ready to bring your skills, compassion, and dedication to a team making a difference every day, we want to hear from you!

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    Managed Care Coordinator • New York, NY, US