About this opportunity
MJHS lists this Pre-Authorization RN - $15,000 Sign-On Bonus or Student Loan Assistance! opportunity in clifton, New Jersey. Review the employer’s description below for duties, qualifications and application requirements.
Job description
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.
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. 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 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
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.