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MJHS

Pre-Authorization RN - $15,000 Sign-On Bonus or Student Loan Assistance!

MJHS, New York, New York, us, 10261

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Overview Pre-Authorization RN - $15,000 Sign-On Bonus or Student Loan Assistance!

Base pay range: $90,000.00/yr - $110,000.00/yr

Location:

New York, NY

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are addressing patient and member needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Even in a non-clinical role, employees have an opportunity to positively impact the quality of our health plan members' lives.

Process all requests for services in accordance with Medicare and NYS Medicaid Guidelines as well as departmental criteria and guidelines. Works collaboratively with other disciplines including Care Manager, Assessment Nurse and Primary Care Physician or other Specialists as necessary to ensure timely provision of services. Coordinates timely completion of UAS NY assessment that accurately reflects current condition of the member. Ensures that the member’s Individualized Person Centered Care Plan has been updated and accurately reflects present status of the member.

Responsibilities

Process requests for services in accordance with Medicare and NYS Medicaid Guidelines and departmental criteria.

Collaborate with Care Manager, Assessment Nurse, Primary Care Physician, and other Specialists to ensure timely provision of services.

Coordinate timely completion of UAS NY assessment reflecting current member condition.

Ensure the member’s Individualized Person Centered Care Plan is updated to reflect current status.

Qualifications

Graduate of an accredited nursing program, Bachelor’s preferred

Current NY RN license and registration required

CCM preferred

Minimum three to five years nursing experience in long term care, managed care, home care, geriatrics or hospice

Prior experience in an interdisciplinary service delivery environment preferred

Working knowledge of Medicare and Medicaid regulations

Working knowledge of Windows, Word and Excel

Knowledge of current standards of medical practice and healthcare delivery systems

Strong assessment skills

Knowledge of Interqual preferred

Seniority level

Mid-Senior level

Employment type

Full-time

Job function

Health Care Provider

Industries

Hospitals and Health Care

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