Join MJHS as a Pre-Authorization RN and play a crucial role in enhancing the quality of healthcare for our members. You'll collaborate with healthcare professionals to ensure timely access to services, making a significant impact on patient care.
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 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
Strong assessment skills
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