Current jobs related to Pre-authorization Unit Supervisor - New York - MJHS

  • Pre Authorization Supervisor

    6 days ago

    New York, United States Onet-Systems Full time

    We are an established out-of-network medical billing company located in New Hyde Park and Merrick, Long Island. We are looking for a detail-oriented Pre-Authorization Medical Billing Supervisor to lead our pre-authorization team. The ideal candidate will be responsible for overseeing the pre-authorization process for medical services, ensuring compliance...

  • Pre-Authorization Nurse Supervisor

    3 weeks ago

    New York, New York, United States RCM Health Care Services Full time

    Job SummaryThe Pre-Authorization Nurse Supervisor is responsible for overseeing the day-to-day operations of the Pre-Authorization Unit at RCM Health Care Services. This role involves reviewing data to ensure compliance with regulatory requirements, providing guidance on complex cases, and monitoring pending cases. The successful candidate will have a strong...

  • Pre-Authorization Medical Billing Team Lead

    5 days ago

    New York, New York, United States Onet-Systems Full time

    Job Title: Pre-Authorization Medical Billing SupervisorWe are seeking a detail-oriented Pre-Authorization Medical Billing Supervisor to lead our pre-authorization team at Onet-Systems. As a key member of our team, you will be responsible for overseeing the pre-authorization process for medical services, ensuring compliance with insurance requirements, and...

  • Pre-Authorization Representative

    1 month ago

    New York, United States Weill Cornell Medical College Full time

    Title: Pre-Authorization Representative Location: Upper East Side Org Unit: Revenue Cycle and Compliance Work Days: Monday-Friday Weekly Hours: 35.00 Exemption Status: Non-Exempt Salary Range: $22.11 - $26.04 *As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices Position Summary Under direction,...

  • Insurance Authorization Supervisor

    4 weeks ago

    Melville, New York, United States Catholic Health Full time

    Overview:Catholic Health stands as a premier provider of health and human services on Long Island. Our extensive health system encompasses over 16,000 dedicated employees, six acute care hospitals, three nursing facilities, a home health service, hospice care, and a comprehensive network of physician practices throughout the region.At Catholic Health, our...

  • Authorization Specialist

    4 months ago

    New York, United States New York Cancer & Blood Specialists Full time

    Job DescriptionJob DescriptionAuthorization SpecialistRidge, NYAt New York Cancer & Blood Specialists (NYCBS), we foster an environment where passionate professionals thrive. Our 200+ oncologists, hematologists, and staff across 25 locations are united by a mission: redefining what's possible against cancer and blood disorders. With cutting-edge...

  • Unit Supervisor

    3 days ago

    New York, United States City of New York Full time

    Company DescriptionJob Description The Protective/ Diagnostic (PD) located across all five boroughs investigates reports of alleged child abuse and neglect. The PD child protective team is the largest within DCP, and the largest in each of the Borough offices. Child protective staff is responsible for investigating every allegation that is reported, and also...

  • PACU Pre Op Manager FT

    1 day ago

    New York, New York, United States United Surgical Partners Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Medical Office Secretary to join our team at NYU Langone Health. As a key member of our Occupational Health Services department, you will provide exceptional support to our patients and staff, ensuring seamless operations and excellent patient care.Key ResponsibilitiesProvide reception...

  • Nursing Unit Supervisor

    1 month ago

    New York, New York, United States CATA Personnel Services Inc. Full time

    Join CATA Personnel Services Inc. as a full-time Nursing Unit Supervisor and take on a vital role in guiding our committed team of healthcare professionals. As a Nursing Unit Supervisor, you will manage the daily functions of your nursing unit, oversee and direct staff Registered Nurses, and implement best practices to maintain our dedication to exceptional...

  • Customer Service Supervisor

    3 weeks ago

    New York, New York, United States Unifi Full time

    Job SummaryUnifi is seeking a highly skilled and customer-focused individual to join our team as a Passenger Service Supervisor. As a key member of our airport operations team, you will be responsible for providing exceptional customer service to our passengers, ensuring a smooth and efficient travel experience.Key ResponsibilitiesAssist passengers with...

  • Pre-Placement Staff Nurse

    3 months ago

    New York, United States City of New York Full time

    Company DescriptionJob Description THE SELECTED CANDIDATE WILL BE OFFERED A FLAT RATE SALARY OF $100,750.00. The Administration for Children's Services (ACS) protects and promotes the safety and well-being of New York City's children and families by providing child welfare, juvenile justice, and early care services. In child welfare, ACS contracts with...

  • Unit Supervisor

    2 days ago

    New York, New York, United States City of New York Full time

    Job Title: Unit SupervisorAs a Unit Supervisor with the City of New York, you will play a critical role in ensuring the safety and well-being of children in our community. This position requires a strong leader who can supervise a team of Child Protective Specialists and provide guidance and support to help them achieve their goals.Key...

  • Teller Unit Supervisor

    4 weeks ago

    New York, New York, United States Apple Bank Full time

    Position OverviewThe Assistant Operations Supervisor plays a vital role in overseeing the Teller Unit, ensuring exceptional customer service while managing transactions and addressing client concerns. This position supports the Operations Supervisor in the effective administration of all Teller unit operations, including daily tasks, technical assistance,...

  • Prior Authorization Review Specialist

    2 weeks ago

    New York, New York, United States MetroPlus Health Plan Full time

    Job SummaryWe are seeking a skilled Prior Authorization Review Technician to join our team at MetroPlus Health Plan. As a key member of our Pharmacy department, you will be responsible for reviewing and processing prior authorization requests, ensuring accurate and timely decision-making.Key ResponsibilitiesInput and review prior authorization requests,...

  • Prior Authorization Review Specialist

    2 weeks ago

    New York, New York, United States MetroPlus Health Plan Full time

    Job SummaryWe are seeking a skilled Prior Authorization Review Technician to join our team at MetroPlus Health Plan. As a key member of our Pharmacy department, you will be responsible for reviewing and processing prior authorization requests, ensuring accurate and timely decision-making.Key ResponsibilitiesInput and review prior authorization requests,...

  • Unit Supervisor

    4 weeks ago

    New York, United States HeartShare St. Vincent's Services Full time

    Job SummaryHeartShare St. Vincent’s Services (HSVS) Enhanced Family Foster Care (EFFC) program seeks a Unit Supervisor for its Queens office to build and lead a strong team that provides and coordinates excellent quality care, and healing to children, and ensures that every one of the children on the caseload is living a nurturing, safe, and permanent...

  • Nursing Unit Supervisor

    1 week ago

    New York, New York, United States Inners Creek Nursing & Rehab - Dallastown, PA Full time

    Join Inners Creek Nursing & Rehab - Dallastown, PA as a Registered Nurse Supervisor and take on a leadership role in delivering high-quality patient care. As a key member of the nursing team, you will be responsible for leading, guiding, and directing the clinical operations of the nursing units on assigned shifts. Your expertise will ensure compliance with...

  • Nursing Unit Supervisor

    2 weeks ago

    New York, New York, United States Lopatcong Center - Phillipsburg, NJ Full time

    Lead Nursing Unit Supervisor OpportunityWe are seeking a skilled and experienced Registered Nurse to join our team as a Lead Nursing Unit Supervisor at Lopatcong Center in Phillipsburg, NJ. As a key member of our nursing leadership team, you will play a vital role in ensuring the delivery of high-quality patient care and promoting a positive work...

  • Authentication and Authorization Specialist

    3 weeks ago

    New York, New York, United States American Express Full time

    About the RoleWe are seeking a highly skilled Software Engineer I to join our Enterprise Identity team at American Express. As a key member of our agile team, you will be responsible for driving the strategy and implementation of our global authentication and authorization platform across all American Express applications.Key ResponsibilitiesDesign and...

  • Pharmacy Technician

    1 week ago

    New York, New York, United States MetroPlusHealth Full time

    Empower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that healthcare is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About MetroPlusHealthMetroPlusHealth provides the highest quality...

Pre-authorization Unit Supervisor

4 months ago

New York, United States MJHS Full time

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 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.
- 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 Registured 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.