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Prior Authorization Nurse

A-Line Staffing Solutions Sacramento Full-Time
$106,080.00/ year
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WHAT YOU'LL DO:

  • Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations.
  • Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings.
  • Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member care.
  • Conduct discharge planning.

WHAT’S GREAT ABOUT THIS POSITION?

  • Full-time opportunity with a Fortune 100 Healthcare Company
  • Office based position.  No options to work remotely.
  • Rapid growth and advancement opportunities.
  • Competitive benefits

QUALIFICATIONS:

  • Current Registered Nurse or Licensed Vocational Nurse License in the State of California
  • Associate in Nursing required or BSN
  • 2+ years prior authorization, utilization management and/or concurrent review experience
  • Previous managed care preferred

 CONTACT: ALLISTON BROWN  / Phone number blocked - click to apply OR Phone number blocked - click to apply, EXT. 229

registered nurse, RN, nurse, LVN, licensed vocational nurse, utilization review, managed care, concurrent review, insurance, prior authorization, telephone

Recommended skills

Utilization Management
Clinical Works
Decision Making
Prior Authorization
Registered Nurse Certified
Medical Necessity

Location

About the company

Salary Details

This salary was provided in the Job Posting.
$106,080
Yearly Salary
This salary is within the average salary range of $70,720-$106,850 for this role in this location

Career Path

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Prior Authorization Nurse
$106,080.00/ year
Estimated Salary: $87K
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