Pre-Authorization RN - $15,000 Sign-On Bonus or Student Loan Assistance!
MJHS
Glendale, NY
1 day ago
$80k - $95k
Job Description
Join MJHS as a Pre-Authorization RN, where you will play a crucial role in ensuring timely healthcare services for our members. Your expertise will directly impact the quality of care and independence of those we serve in our Medicare and Medicaid managed care health plans.
Key Responsibilities
Process all requests for services in accordance with Medicare and NYS Medicaid Guidelines
Collaborate with Care Managers, Assessment Nurses, and Primary Care Physicians to ensure timely provision of services
Coordinate timely completion of UAS NY assessments
Update and maintain the member’s Individualized Person Centered Care Plan
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