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Prior Authorization Nurse 2

Apex Systems Sacramento Contractor
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Apex Systems, the second largest staffing and services firm is looking for a Prior Authorization Nurse to join one of our top Healthcare client in Sacramento, CA!  Please see the job requirements below.

Job Title: Prior Authorization Nurse
Company: Apex Systems

Perform telephonic review of prior authorization 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 case management team electronically or telephonically to coordinate member care.

Educate providers on utilization and medical management processes.

Provide clinical knowledge and act as a clinical resource to non-clinical team staff.

Enter and maintain pertinent clinical information in various medical management systems

Requirements:

  • Active LPN OR RN License
  • 2-4  years of nursing experience
  • Previous Prior Authorization experience REQUIRED

About Apex:

For over 20  years, Apex has been connecting top professionals with positions at great companies in contract, contract-to-hire, and direct hire positions. We support thousands of job openings per year at companies across North America.

As an employee of Apex, you are valued and part of the Apex family. We provide each employee with an industry-leading benefits program that is designed to support your health, your planning for the future, and your career development.

Apex has resources to support your long-term career and personal development through internal development programs, technical seminars, certification preparation, and certification exam vouchers.

Apex offers several benefits and resources for their employees:

  • Health Insurance
  • Vision and Dental
  • Life Insurance
  • Short and Long Term Disability
  • 401k options
  • Training and Development Programs

To learn more, visit our website: URL blocked - click to apply

EEO Employer

Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178

 

Recommended skills

Case Management
Clinical Works
Decision Making
Prior Authorization
Medical Management
Management Systems

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Prior Authorization Nurse 2
Estimated Salary: $88K
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Job ID: 997649

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WHAT WE DO:

Apex Systems is a division of the 2nd largest IT staffing and services firm in North America. From consulting to staff augmentation, we connect top tech talent with great companies in all industries.

OUR CREDENTIALS: 

Apex earned Inavero’s Best of Staffing™ Client Diamond and Talent Awards for providing superior service to clients and job seekers, putting the company in the top 2 percent of all U.S. staffing agencies.

SUPPORTING OUR CONTRACT EMPLOYEES:

We take the time to understand a candidate’s talents and needs to ensure a good match with companies for contract, contract-to-hire, and direct hire positions. Each recruiter within Apex is focused on a specific skill area within infrastructure, applications, and project management. This focused discipline enables our local recruiters to work directly with our candidate’s and focus their talent on the right position at the right time.

WHO OUR CUSTOMERS ARE: 

We serve Fortune 500, mid-market, and emerging companies from a wide variety of industries, including communications, energy, financial services, government services, healthcare, technology, and utilities. 

WHERE WE ARE: 

Apex has branches in over 70 locations across the U.S. and Canada and more than 1,000 employees dedicated to supporting the needs of our clients and contract team members. Visit www.apexsystems.com to find a local branch or connect with an Account Manager or Recruiter.

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