Pre-Authorization Nurse LPN - New York, New York, United States
1 day ago
Job description
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.
The MJHS Difference
At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.
Benefits include:
- Sign-on Bonuses OR Student Loan Assistance for clinical staff
- Tuition Reimbursement for all full and part-time 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)
Responsibilities
Process requests for selected elective services, out of network requests, out of area requests and durable medical equipment in accordance with departmental criteria, regulatory standards, and Medicare guidelines. Communicates all elective hospital admissions to the appropriate Utilization Management Coordinator and/or Care Manager to ensure timely receipt of information and continuity of member care.
Ensures that authorizations are appropriate, and determinations are made and documented to facilitate claims processing, integrity of data record, and to minimize unnecessary retrospective review.
Applies program criteria to identify members for Care Management and Geriatric Case Management during the pre-authorization, concurrent review, and discharge planning process.
Qualifications
Graduate of an accredited Practical Nursing Program; current LPN NY license and registration required. Minimum of 1-3 years Medical/Surgical nursing experience; prior managed care experience preferred; familiarity with Utilization management processes preferred. Working knowledge of Windows, Word and Excel. Knowledge of current standards of medical practice and healthcare delivery systems. Excellent written and oral communication skills. Good analytical abilities.
Min
USD $60,673.04/Yr.
Max
USD $75,841.30/Yr.
Similar jobs
Community Healthcare Network is looking for a Full-Time Nurse/LPN II who will be a key member of the health care team covering at different centers. · ...
1 month ago
Provides triage nursing and dispenses medication to clients. · Dispenses physician prescribed non Methadone and Methadone medications. · Reports to the disciplinary team on medical clinical client in response to treatment protocols. · ...
1 month ago
We are looking for a Full-Time LPN I who will be a key member of the health care team covering at different centers. · ...
1 week ago
· Full-time · Description · BASIC FUNCTION: Provides triage nursing and dispenses medication to clients. · MAJOR DUTIES: · Dispenses physician prescribed, non-Methadone and Methadone medications. · Reports to the disciplinary team on medical/clinical client in response to treatm ...
1 day ago
We are looking for a LPN Nurse Administrator to supervise assigned staff and assist clients in administering medication. · We offer competitive health insurance and paid sick time benefits immediately upon starting work. · ...
1 month ago
We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. · Find Meaningful work in One-on-One Care at BAYADA · If you're an LPN in New York Ci ...
3 weeks ago
We are seeking a dedicated and compassionate Licensed Practical Nurse (LPN) for a 13-week assignment in a Skilled Nursing Facility (SNF). This position offers a guaranteed 40 hours per week, · Deliver direct patient care in accordance with the plan of care under the supervision o ...
1 month ago
We thrive on making our residents and staff as comfortable and happy as possible. We provide our team with everything necessary to help you succeed and grow. · ...
1 week ago
LPN (Licensed Practical Nurse)
The Riverside Premier Rehabilitation and Healing Center
We are looking for a talented and motivated Licensed Practical Nurse (LPN) to join our dynamic team. · Candidate should possess passion for geriatric population, must contain a license, be able to evaluate and treat independently without direct supervision, and posses the desire ...
2 days ago
+ Immediate Start · We are looking for LPN (Licensed Practical Nurse) to care for our patients and facilitate their speedy recovery. · Responsibilities include monitoring patient's condition, observing symptoms, collaborating with physicians and nurses, · fostering a supportive e ...
1 week ago
We are looking for compassionate and dedicated Licensed Practical Nurses (LPN) to join our dynamic team. As an LPN, you will work under the supervision of Registered Nurses (RNs) to provide direct patient care. · Provide direct patient care. · Assist patients with daily living ac ...
2 days ago
LPN (Licensed Practical Nurse)
The Riverside Premier Rehabilitation and Healing Center
Join our team at The Riverside Premier Rehabilitation and Healing Center. As a skilled Licensed Practical Nurse (LPN), you will provide high-quality patient care in our dynamic environment. · Duties Include: · Medication Administration, including IVs · Taking and recording vital ...
3 days ago
+The Allure Group is looking for a Licensed Practical Nurse (LPN) to join the team at our Skilled Nursing Facility in Brooklyn, NY. · +Make rounds to observe residents and nursing care · Review and integrate the Nursing Care Plan to reflect physical emotional restorative rehabili ...
1 month ago
St. Patrick's Home Rehabilitation and Health Care · is actively seeking a · Licensed Practical Nurse (LPN) · for our Skilled Nursing Facility in the · Bronx, NY · . · Duties: · Collecting required information from new Residents to be admitted · Recording health details of Residen ...
3 hours ago
We are currently looking for compassionate and dedicated Licensed Practical Nurses (LPN) to join our dynamic team. · ...
1 week ago
We are currently looking for compassionate and dedicated Licensed Practical Nurses (LPN) to join our dynamic team. · As an LPN, you will work under the supervision of Registered Nurses (RNs) to provide direct patient care, supporting individuals with their health needs. · ...
1 week ago
· Empro Staffing is a leading provider of supplemental personnel for the healthcare industry, dedicated to offering exceptional nursing professionals across every position and specialty in healthcare facilities throughout the United States. With decades of experience, Empro Staf ...
1 day ago
Join a Company That Puts People First · Licensed Practical / Vocational Nurse – LPN/LVN · We are one of the largest private duty nursing companies in the nation and growing At Aveanna, we're proud to foster a workplace culture that celebrates diversity, encourages connection, and ...
23 hours ago
The challenges of affordable healthcare create new opportunities. Elderplan and HomeFirst are examples of how we are expanding services in response to our patients' and members' needs. · ...
6 days ago
The challenges of affordable healthcare continue to create new opportunities. · We foster collaboration and celebrate achievements while providing high-quality health care services. · ...
1 week ago