PreAuthorization RN - Registered Nurse Care Manager for Managed Care

Job Description
Compass Healthcare Consulting & Placement is conducting a search for an experienced Pre-Authorization RN - Registered Nurse for a large Managed Long Term Care Plan located in Brooklyn, NY. Qualified Candidates will have prior experience with Pre-authorization and MLTC Case Management.

Pre-Authorization Nurse - RN Care Manager for MLTC

Process all Preauthorization 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.

Understands UAS NY assessment which accurately reflects current condition 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 3 - 5 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:

• Sign-On Bonus!
• Employee and family health coverage
• Competitive salaries
• Employer contributed pension plan
• Generous time off
• Tuition reimbursement
• Retirement Plan

Qualified Candidates Please Apply Now for Immediate Consideration!

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