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Pre-Authorization RN

MJHS

Manhattan, NY
1 day ago
$85k - $105k

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 play a vital role in ensuring timely healthcare services for our members. Utilize your nursing expertise to coordinate care and improve the quality of life for those we serve.

Key Responsibilities

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

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

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
  • Strong assessment skills
  • Working knowledge of Windows, Word and Excel

Benefits & Perks