Prior Authorization Registered Nurse

Job Description

We are aggressively seeking a Provider Network Coordinator to join a large Healthcare organization. As the year 2016 is in full swing, this organization is very busy, and they need your help.

This exciting opportunity requires a Prior Authorization Registered Nurse who can provide a high level of service and attention to patients. If you are a seasoned Prior Authorization Registered Nurse and meet the qualifications listed below, please apply below for consideration.

• Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options.
• Utilize assessment skills and discretionary judgment to develop a plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes.
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers and non-medical staff as necessary to meet the complete medical socio-economic needs of clients.

Monday – Friday 9:00 am – 6:00 pm or 8:00 am – 5:00 pm.

• Competitive salary, negotiable based on relevant experience.
• Benefits offered:
  Medical, Dental, and Vision.
• Fun and positive work environment.
• Negotiated based on relevant job experience.

• Active/Compact State’s RN License.
• 1 year of case management experience.
• Experience with medical decision support tools (e.g., Interqual, Milliman, NCCN) and government-sponsored managed care programs is preferred.

If you are interested in applying for this position, please click the Apply button below.