Join MJHS as a Pre-Authorization RN and play a vital role in enhancing the quality of life for our health plan members. You will ensure timely service provision and collaborate with healthcare professionals to deliver exceptional care.
Key Responsibilities
Process requests for services according to Medicare and NYS Medicaid Guidelines
Collaborate with Care Manager, Assessment Nurse, and Primary Care Physician
Coordinate timely completion of UAS NY assessments
Update Individualized Person Centered Care Plans
Required Qualifications
Graduate of an accredited nursing program
Current NY RN license and registration
Minimum three to five years nursing experience
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