Job Description
The challenges of affordable healthcare continue tocreate new opportunities. Elderplan and HomeFirst, our Medicare andMedicaid managed care health plans, are outstanding examples of howwe are expanding services in response to our patients' and members'needs. These high-quality healthcare plans are designed to helpkeep people independent and living life on their own terms. Even ina non-clinical role, employees have an opportunity to make apositive impact on the quality of our health plan members' lives.As a Pre-Authorization Nurse, you will process all requests forservices in accordance with Medicare and NYS Medicaid Guidelines aswell as departmental criteria and guidelines. You will workcollaboratively with other disciplines including Care Manager,Assessment Nurse and Primary Care Physician or other Specialists asnecessary to ensure timely provision of services. You willcoordinate timely completion of UAS NY assessment that accuratelyreflects current condition of the member. You will ensure that themember's Individualized Person Centered Care Plan has been updatedand accurately reflects present status of the member.
