Pre-Authorization RN Job at MJHS (New York)

Pre-Authorization RN

MJHS

Location:
United States , New York

Category:
Nursing

Contract Type:
Not provided

Salary:

90000.00 - 110000.00 USD / Year

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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.

Job Responsibility:

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

Requirements:

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
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

Nice to have:

Knowledge with Utilization management processes preferred
CCM preferred
Prior experience in an interdisciplinary service delivery environment preferred
Knowledge of Interqual preferred

What we offer:

Sign-on Bonuses OR Student Loan Assistance for clinical staff
FREE Online RN to BSN and MSN degree programs
Tuition Reimbursement for all full and part-time staff
Dependent Tuition Reimbursement for clinical staff
Generous paid time off, including your birthday
Affordable and comprehensive medical, dental and vision coverage for employee and family members
Two retirement plans! 403(b) AND Employer Paid Pension
Flexible spending
And MORE
MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Additional Information:

Job Posted:
February 01, 2026

Employment Type:

Fulltime

Work Type:

Remote work

MJHS - All Job Offers

Job Link Share:

Pre-Authorization RN

MJHS

Location:
United States , New York

Category:
Nursing

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
February 01, 2026

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Pre-Authorization RN

MJHS

Location:United States , New York

Category:Nursing

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:February 01, 2026

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