Join MJHS as a Pre-Authorization RN where you will play a vital role in ensuring timely healthcare services for our members. Your expertise will help improve the quality of life for those we serve.
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
Coordinate timely completion of UAS NY assessment
Update and ensure accuracy of the member’s Individualized Person Centered Care Plan
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
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