Metropolitan Jewish Health System

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

Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Graduate of an accredited nursing program; Bachelor's degree preferred
  • Experience with Utilization management processes preferred
  • Active NY RN license and registration required
  • Certified Case Manager (CCM) preferred
  • 3-5 years of nursing experience in relevant fields like long-term care or geriatrics
  • Familiarity with Medicare and Medicaid regulations
  • Proficient in Windows, Word, and Excel

Responsibilities

  • Process requests for services according to Medicare and NYS Medicaid guidelines
  • Collaborate with Care Manager, Assessment Nurse, and other relevant professionals
  • Coordinate timely completion of UAS NY assessments
  • Update the member's Individualized Person-Centered Care Plan accurately
  • Ensure provision of services is timely and compliant with standards

Benefits

  • Remote work available after training
  • Regular full-time position
  • Work in a collaborative interdisciplinary team
  • Engagement in ongoing professional development opportunities
Full Job Description
Req #:
4353
Job ID:
15762
Job Location:
Nassau County, NY
Zip Code:
11572
Category:
Managed Care Nursing
Agency:
Elderplan
Status:
Regular Full-Time
Office:
Remote After Training

Salary:
$90,000.00 - $110,000.00 per year

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. 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

About Metropolitan Jewish Health System

Metropolitan Jewish Health System is a non-profit organization that provides health care services to seniors and individuals with chronic illnesses in the New York City area. The organization was founded in 1907 and has since grown to become one of the largest providers of home health care, hospice care, and long-term care in the region. Metropolitan Jewish Health System's services include skilled nursing, rehabilitation, palliative care, and social work. The organization is committed to providing high-quality, compassionate care to its patients and their families. Metropolitan Jewish Health System is headquartered in Brooklyn, New York.
Learn more about Metropolitan Jewish Health System
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