Responsibilities

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The Pre-Authorization Nurse (RN) will: Process all requests for services in accordance with Medicare and NYS Medicaid Guidelines as well as departmental criteria and guidelines Work 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 the timely completion of UAS NY assessment that accurately reflects current condition of the member Ensure that the member’s Individualized Person Centered Care Plan has been updated and accurately reflects present status of the member Perform other duties, as needed Qualifications: Graduate of an accredited School of Nursing NYS Registered Nurse (RN) license UAS/Utilization Review experience Desired Skills: Bachelor's Degree in Nursing Interqual experience CCM certification is a plus