Pre-Authorization RN - $15,000 Sign-On Bonus or Student Loan Assistance!
MJHS
Williamsburg, VA
4 days ago
$70k - $90k
Job Description
Join MJHS as a Pre-Authorization RN and play a vital role in ensuring high-quality healthcare services for our members. Collaborate with interdisciplinary teams to enhance patient care and support independence.
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 or other Specialists
Coordinate timely completion of UAS NY assessment
Ensure the member’s Individualized Person Centered Care Plan is updated and accurately reflects present 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