NYC Health + Hospitals

Senior Hospital Care Investigator

NYC Health + Hospitals$75K — $95K *
Hospitals & Medical Centers
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Minimum of six months experience as a Hospital Care Investigator.
  • Proven supervisory skills in managing investigative units.
  • Strong understanding of medical assistance eligibility criteria.
  • Ability to interpret and apply complex regulatory guidelines.
  • Experience in conducting detailed investigations and case reviews.

Responsibilities

  • Supervise a unit conducting investigations related to medical assistance eligibility.
  • Assign and control workflow within the unit, ensuring efficiency.
  • Train and guide staff on complex or difficult investigative matters.
  • Review and evaluate case records for approval or denial of assistance.
  • Authorize medical assistance for inpatient care and determine eligibility for services.
  • Conduct special investigations as needed for complex cases.
  • Maintain statistical records and prepare comprehensive status reports.

Benefits

  • Comprehensive health benefits for employees working 20+ hours weekly.
  • Retirement savings and pension plans for long-term security.
  • Paid holidays and vacation, with adherence to collective bargaining agreements.
  • Loan forgiveness programs available for eligible staff.
  • Opportunities for college tuition discounts and professional development.
  • Participation in college savings programs to support educational goals.
  • Union benefits applicable to eligible job titles.
  • Access to multiple employee discount programs.
  • Commuter benefits to support travel expenses.
Full Job Description
Work Shifts

9:00 A.M - 5:00 P.M

Duties & Responsibilities

Purpose of Position:

Under general supervision, supervisions a unit conducting investigations in hospitals to determine eligibility of applicants for medical assistance at public expense, or a unit reviewing applications or conducting investigations of non-hospitalized and noninstitutionalized applicants for medical assistance, or a unit of Hospital Care Investigators engaged in other related activity; performs related work.

Examples of Typical Tasks:
1. Supervises a unit engaged in medical assistance, investigation activities, assigning and controlling the flow of work, training and advising subordinates in difficult matters, evaluating staff and recommending appropriate personnel action when indicated.
2. Reviews case records and/or recommendations for approval or denial and for appropriateness of category of assistance.
3. Authorizes or denies medical assistance for inpatient care and determines eligibility for other medical assistance.
4. May conduct special or emergency investigations, or investigations of a more difficult or complex nature.
5. Interprets departmental, City, State and Federal rules and regulations for the unit staff.
6. Maintains statistical records and prepares status reports.

Minimum Qualifications

Six months of service as a Hospital Care Investigator.

Benefits

NYC Health and Hospitals offers a competitive benefits package that includes:
  • Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
  • Retirement Savings and Pension Plans
  • Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
  • Loan Forgiveness Programs for eligible employees
  • College tuition discounts and professional development opportunities
  • College Savings Program
  • Union Benefits for eligible titles
  • Multiple employee discounts programs
  • Commuter Benefits Programs


If you wish to apply for this position, please apply online by clicking the "Apply for Job" button.

About NYC Health + Hospitals

NYC Health + Hospitals is a healthcare system that provides medical care to residents of New York City. The system was founded in 1969 and is headquartered in New York, New York. NYC Health + Hospitals has a network of hospitals, clinics, and other healthcare facilities throughout the city. The system provides a wide range of medical services, including primary care, specialty care, and emergency care. NYC Health + Hospitals is committed to providing high-quality, affordable healthcare to all New Yorkers, regardless of their ability to pay.
Learn more about NYC Health + Hospitals
Size
42,000 employees
Industry
Net Income
-$500,000
5 Year Trend
-10%
Revenue
$7 billion

Similar Jobs

More Jobs at NYC Health + Hospitals

More Hospitals & Medical Centers Jobs

Find similar Senior Hospital Care Investigator jobs: