Pre-Authorization Nurse Supervisor / RN

*Pre-Authorization Unit Supervisor / RN / Hybrid / Manhattan*
NY based high-quality Medicare and Medicaid health plans designed to help keep people independent and living life on their own terms. Hybrid role - Combinations office based in Downtown, Manhattan and Work from Home. *Salary*: $102,000 to - $125,000 ( Depending on Experience )
Hybrid work schedule. 2 days per week in Manhattan office, 3 days are work from home.

*Summary:*

The supervisor in this position is responsible for the oversight of the overall day to day functioning of the MLTC/DSNP pre-authorization functions. The supervisor’s daily oversight includes reviewing data to monitor regulatory requirements (standard/expedited time frames, org determination outcomes and communication, inter-rater reliability), provides direction for complex cases, monitors pending cases, reviews and educates staff on new criteria trends (including InterQual, local carrier policy, national coverage determinations), and acts as a liaison with interdepartmental communication.

*Qualifications:*
* Graduate of an accredited nursing program: baccalaureate degree preferred.
* Minimum one to three years' previous management experience preferred.
* Previous managed care experience in the areas of utilization management and/or case management preferred.
* Minimum one year nursing practice in clinical settings, i.e. hospital, nursing facility or home health.
* Licensed to practice as a Registered Nurse in the state of New York with current registration.
* CCM preferred
* Knowledge of InterQual preferred.
* Knowledge of Federal and State regulatory requirements for managed care.

*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!

INDP

Job Type: Full-time

Pay: $115,000.00 - $125,000.00 per year

Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Health insurance
* Life insurance
* Paid time off
* Vision insurance

Work Location: In person