Pre-Authorization RN - Utilization & Care Coordination

Metropolitan Jewish Health System; New York (NY); On-site; USD 90,000 - 110,000; Full time

Benefits offered by this job

Sign-on bonus

Student loan assistance

Tuition reimbursement

Dependent tuition reimbursement

Paid time off including birthday

Medical/dental/vision coverage for you

Retirement plans (403(b) & employer‑p­

Employer‑paid pension

Flexible spending

PSLF eligibility

Job summary

Metropolitan Jewish Health System is seeking an experienced registered nurse to manage service requests under Medicare and NYS Medicaid guidelines. You will collaborate with care teams to ensure timely service delivery and update UAS NY assessments for accuracy.

Ideal candidates hold NY RN licensure, 3–5 years in long-term care or managed care, and knowledge of Medicare/Medicaid regulations. Proficiency with Windows, Word, and Excel is expected.

Qualifications

• NY RN license and registration required.
• 3–5 years nursing experience in long-term care, managed care, home care, geriatrics or hospice.
• Knowledge of Medicare/Medicaid regulations.
• Interdisciplinary service delivery experience preferred.
• Proficient with Windows, Word, and Excel.

Responsibilities

• Processes all requests for services per Medicare and NYS Medicaid guidelines.
• Collaborates with Care Manager, Assessment Nurse and Primary Care Physician to ensure timely services.
• Coordinates timely completion of UAS NY assessments reflecting current member condition.
• Ensures Individualized Person-Centered Care Plans reflect present status.

Skills

Nursing

Utilization management

Interdisciplinary collaboration

Assessment skills

Medicare/Medicaid regulations

Education

RN license

Bachelor's degree preferred

Tools

Windows

Word

Excel

Job description

Metropolitan Jewish Health System is seeking an experienced registered nurse to manage service requests under Medicare and NYS Medicaid guidelines. You will collaborate with care teams to ensure timely service delivery and update UAS NY assessments for accuracy.

Ideal candidates hold NY RN licensure, 3–5 years in long-term care or managed care, and knowledge of Medicare/Medicaid regulations. Proficiency with Windows, Word, and Excel is expected.