MJ
Pre-Authorization RN
full-time•New York•$90k - $110k
About this role
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.
The MJHS Difference
At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.
Benefits include:
- Sign-on Bonuses OR Student Loan Assistance for clinical staff
- FREE Online RN to BSN and MSN degree programs!
- Tuition Reimbursement for all full and part-time staff
- Dependent Tuition Reimbursement for clinical staff!
- Generous paid time off, including your birthday!
- Affordable and comprehensive medical, dental and vision coverage for employee and family members
- Two retirement plans! 403(b) AND Employer Paid Pension
- Flexible spending
- And 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 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
- Prior experience in an interdisciplinary service delivery environment preferred
- 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
Min
USD $90,000.00/Yr.Max
USD $110,000.00/Yr.What you'll do
- Process requests for services according to Medicare and NYS Medicaid guidelines. Collaborate with care managers and physicians to ensure timely provision of services.
About Metropolitan Jewish Health System
MJHS is a large not-for-profit health system in the Greater New York area.
Our range of health services include home care, hospice and palliative care for adults and children, rehabilitation and nursing care at Menorah and Isabella Centers, and the research based MJHS Institute for Innovation and Palliative Care. We also offer Elderplan/HomeFirst: health plans for Medicare and dual-eligible individuals.
As a not-for-profit organization, many of our programs and services are made possible through the generosity of grateful families, corporate donors and grants, as well as our own employees.
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Frequently Asked Questions
What does Metropolitan Jewish Health System pay for a Pre-Authorization RN?
Metropolitan Jewish Health System offers a competitive compensation package for the Pre-Authorization RN role. The salary range is USD 90k - 110k per year. Apply through Clera to learn more about the full compensation details.
What does a Pre-Authorization RN do at Metropolitan Jewish Health System?
As a Pre-Authorization RN at Metropolitan Jewish Health System, you will: process requests for services according to Medicare and NYS Medicaid guidelines. Collaborate with care managers and physicians to ensure timely provision of services..
Is the Pre-Authorization RN position at Metropolitan Jewish Health System remote?
The Pre-Authorization RN position at Metropolitan Jewish Health System is based in New York, United States. Contact the company through Clera for specific work arrangement details.
How do I apply for the Pre-Authorization RN position at Metropolitan Jewish Health System?
You can apply for the Pre-Authorization RN position at Metropolitan Jewish Health Systemdirectly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process.