Pre-Authorization Intake Specialist

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.
When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No? You will here! You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals. You take care of our patients, residents and health plan members, and we will take care of the rest!
Benefits include:
Tuition Reimbursement   for all full and part-time staff Generous paid time off Affordable   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) This position is responsible for the intake process of all Medicaid requests for services in accordance with Medicare and NYS Medicaid Guidelines as well as departmental criteria and guidelines. Works collaboratively with other disciplines including Pre-Authorization RN, Care Manager, Assessment Nurse and Primary Care Physician, or other Specialists, as necessary to ensure timely provision of services. Coordinate timely completion of UAS NY assessment that accurately reflects current condition of the member.
Baccalaureate graduate in health-related field. Knowledge of Utilization management processes preferred. Minimum of 3 years' experience in long term care, managed care, home care, or geriatrics. Working knowledge of Medicare and Medicaid regulations, familiarity with Utilization management preferred. Prior experience in an interdisciplinary service delivery environment preferred. USD $51,304.90/Yr.
USD $105,000.00/Yr.