Join MJHS as a Pre-Authorization RN, where you will play a crucial role in ensuring timely access to healthcare services for our members. Your expertise will help maintain high-quality care and improve the lives of those we serve.
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 assessments
Ensure updates to the Individualized Person Centered Care Plan reflect the member's current 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