• Pre-Authorization RN - $7,500 sign-on bonus!

    Job Locations US-NY-Brooklyn
    Req #
    107120
    Agency
    Elderplan
    Status
    Regular Full-Time
    Location : Postal Code
    11220
    Category
    Managed Care Nursing
    Office or Field
    Office-based
  • 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.

    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

    Benefits

    We truly value our staff and further acknowledge their contributions by offering:

    • Work from home up to 4 days per week after 6 months!
    • Employee and family health coverage
    • Competitive salaries
    • Employer contributed pension plan
    • Generous time off
    • Employee tuition reimbursement
    • Dependent tuition reimbursement
    • 403(b) retirement plan

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