Title: Prior Authorization Nurse
Date Posted: 06/13/2018
Job Type: Right To Hire
Job Location: Lenexa Kansas
Are you an experienced Prior Authorization Registered Nurse looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!
- Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests.
- 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
- Bachelor’s degree in Nursing preferred.
- 2+ years of clinical nursing experience.
- Knowledge of healthcare and managed care preferred.
- Discharge planning experience (please notate on resume)
Hours for this Position:
Mon - Fri 8 am - 5 pm
Advantages of this Opportunity:
- Competitive salary, negotiable based on relevant experience
- Benefits offered, Medical, Dental, and Vision
- Fun and positive work environment
Why You Should Work For Us:
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Interested in being Considered?
If you are interested in applying to this position, please click Apply Now or email your resume directly.