Pre-Authorization RN - $15,000 Sign-On Bonus or Student Loan Assistance!
MJHS
Sunnyside, NY
1 day ago
$80k - $100k
Job Description
Join MJHS as a Pre-Authorization RN and make a positive impact on the lives of our health plan members by ensuring timely access to essential services. Collaborate with a dedicated team to provide high-quality healthcare solutions.
Key Responsibilities
Process 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 assessments
Update Individualized Person Centered Care Plans to reflect current status of members
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