Join MJHS as a Pre-Authorization RN and make a meaningful impact in the lives of Medicare and Medicaid members. In this role, you'll ensure timely provision of services and collaborate with healthcare professionals to enhance patient care.
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
Coordinate timely completion of UAS NY assessment
Update Individualized Person Centered Care Plans to reflect member status
Required Qualifications
Current NY RN license and registration
Graduate of an accredited nursing program
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