Pre-Authorization Intake Specialist

Req #:

4010

Job ID:

15413

Job Location:

New York, NY

Zip Code:

10041

Category:

Office and Administrative Support

Agency:

Elderplan

Status:

Regular Full-Time

Office:

Office

Salary:

$51,304.90 - $64,131.12 per year

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:

• 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:

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.

Qualifications:

• 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.

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