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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