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

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.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.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