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

Responsibilities

• Processes 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.
• Captures and updates UAS NY assessment that accurately reflects current condition of the member.
• Safeguards and updates the member’s Individualized Person-Centered Care Plan to reflect the current status of the member.

Requirements

• Graduate of an accredited nursing program, Bachelor’s preferred
• Knowledge with Utilization management processes 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