Join our World Class Healthcare Team as a member of our Continuum of Care Services. Your primary responsibilities will include utilizing your clinical expertise while working closely with the Auth/Cert Department, Physician Offices, and Payers on complex/technically difficult surgical cases to obtain appropriate authorization prior to scheduled procedures. To qualify you must be a creative problem solver with strong Preauthorization skills, Managed Care skills, and Utilization Management. In this highly interactive role you will collaborate with clinicians and caregivers to achieve goals and further refine on-going programs and initiatives.
The successful candidate must be a NYS Licensed RN with solid Utilization Management and/or Managed Care experience. Strong interpersonal skills, proficiency in PC and database management and excellent communication skills are essential. The ability to demonstrate a real understanding of internal mechanisms for hospital care/clinical programs is crucial. Bachelor’s Degree required – UM/CM certification highly desirable.