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Registered Nurse 2 (Medical Care) (NY HELPS), WCB Items #3202, 3217,3573 and 3805

State of New York • Menands, NY, US • published 2026-09-24 22:03:54.954729

Description

Duties Description Under the direction of Registered Nurse Supervisor, SG 23, within the Medical Director's Office's Clinical Standards Unit, the Registered Nurse 2 will be responsible for conducting medical necessity reviews of prior authorization requests for treatment/procedures and/or testing. Specific duties include: * Conduct medical necessity reviews of all prior authorization requests (PARs) for treatment/procedures and/or testing to determine the medical necessity of treatments requested for injured workers in accordance with evidence based Medical Treatment Guidelines to determine if the request meets the criteria for approval in accordance with Section 324 of Title 12 NYCRR (MTG Variances \& Special Services) and Section 441 of Title 12 NYCRR (Drug Formulary) and 442\.2 (Durable Medical Equipment). * Collaborate with MDO staff and providers to ensure continuity of care for injured workers. * Draft and issue Notices of Resolution for all assigned prior authorization requests. * Respond to emails and phone calls to external stakeholders (e.g. injured workers, providers and attorneys) regarding treatment requests, issues with obtaining authorized medications and navigating ...

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