New York, NY, US
3 days ago
Pre-Authorization RN
Welcome page Returning Candidate? Log back in! Job Locations US-NY-New York Req # 1950 Agency Elderplan Status Regular Full-Time Location : Postal Code 10041 Category Managed Care Nursing Office or Field Remote after Training Overview

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' 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 make a positive impact on the quality of our health plan members' lives.

Why work for MJHS?

When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No?  You will here!  You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals.  You take care of our patients, residents and health plan members, and we will take care of the rest!

 

Benefits include:

Sign-on Bonuses OR Student Loan Assistance for clinical staffFREE Online RN to BSN and MSN degree programs!Tuition Reimbursement for all full and part-time staffDependent Tuition Reimbursement for clinical staff!Generous paid time offAffordable medical, dental and vision coverage for employee and family membersTwo retirement plans! 403(b) AND Employer Paid PensionFlexible spendingAnd MORE!

 

MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Responsibilities

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.

Qualifications Graduate of an accredited nursing program, Bachelor’s preferredKnowledge with Utilization management processes preferredCurrent NY RN license and registration requiredCCM preferredMinimum three to five years nursing experience in long term care, managed care, home care, geriatrics or hospicePrior experience in an interdisciplinary service delivery environment preferredWorking knowledge of Medicare and Medicaid regulationsPrior experience in an interdisciplinary service delivery environment preferredWorking knowledge of Windows, Word and ExcelKnowledge of current standards of medical practice and healthcare delivery systemsStrong assessment skillsKnowledge of Interqual preferred Min USD $90,000.00/Yr. Max USD $110,000.00/Yr. Options Apply for this job onlineApplyShareRefer this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Application FAQs

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