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Pre-Authorization RN

MJHS

Ridgewood, NY
1 day ago
$80k - $100k

This Job Position Has Expired

This job listing is no longer available for applications. The position may have been filled or the posting period has ended.

Job Description

Join MJHS as a Pre-Authorization RN and make a meaningful impact on the lives of our health plan members by ensuring timely access to essential services. Collaborate with a dedicated team to support independent living for patients in need.

Key Responsibilities

  • Process all requests for services in accordance with Medicare and NYS Medicaid Guidelines
  • Collaborate with Care Manager, Assessment Nurse, and Primary Care Physician
  • Coordinate timely completion of UAS NY assessment
  • Update Individualized Person Centered Care Plan to reflect current status of the member

Required Qualifications

  • Graduate of an accredited nursing program
  • Current NY RN license and registration
  • Minimum three to five years nursing experience in long term care, managed care, home care, geriatrics or hospice
  • Strong assessment skills

Preferred Qualifications

  • Bachelor’s degree
  • Knowledge with Utilization management processes
  • CCM certification
  • Prior experience in an interdisciplinary service delivery environment
  • Working knowledge of Medicare and Medicaid regulations
  • Knowledge of Interqual
  • Working knowledge of Windows, Word and Excel

Benefits & Perks