Metropolitan Jewish Health System

Pre-Authorization RN

Metropolitan Jewish Health System • $90K — $110K *
Elmhurst, NY 11373In-Person
Healthcare
Less than 5 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Graduate of an accredited nursing program; Bachelor's preferred
  • Experience in utilization management processes is a plus
  • Current NY RN license and registration required
  • CCM certification preferred
  • 3-5 years of nursing experience in long term care, managed care, home care, geriatrics or hospice
  • Familiarity with interdisciplinary service delivery is preferred
  • Strong assessment skills and knowledge of current medical standards and healthcare systems

Responsibilities

  • Process requests for services according to Medicare and NYS Medicaid Guidelines
  • Collaborate with Care Managers, Assessment Nurses, and Primary Care Physicians to ensure timely services
  • Coordinate the completion of UAS NY assessments that reflect member's current condition
  • Update and ensure accuracy of member's Individualized Person-Centered Care Plan
  • Engage with interdisciplinary teams to facilitate integrated care

Benefits

  • Health insurance
  • Retirement plan
  • Paid time off
  • Continuing education support
Full Job Description
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


Min

USD $90,000.00/Yr.

Max

USD $110,000.00/Yr.

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
Industry
Healthcare
* Ladders Estimates

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