M

Pre-Authorization RN

MJHS

Chinatown, NY
1 day ago
$80k - $95k

This Job Position Has Expired

This job listing is no longer available for applications. The position may have been filled or the posting period has ended.

Job Description

Join MJHS as a Pre-Authorization RN and play a vital role in enhancing the quality of healthcare services for our members. Collaborate with a dedicated team to ensure timely provision of care and support for individuals in need.

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
  • Ensure that the member’s Individualized Person Centered Care Plan is updated accurately

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
  • Knowledge of Interqual
  • Strong assessment skills
  • Working knowledge of Windows, Word and Excel

Benefits & Perks