Previous Job
Previous
Prior Authorization Nurse
Ref No.: 17-01935
Category: Permanent Placement
Location: Chatsworth, California
Established Health Plan with a close knit, family feel office environment is seeking an Prior Authorization Nurse in Canoga Park, CA.

Prior Authorization Nurse

Job Summary:
  • Perform clinical review of requests requiring medical review and entering authorizations into the system.
  • Clearly and accurately document on rational for approving request or reason for sending to the Medical Director for additional review.
  • Handle telephone requests timely and accurately.
  • Develop and update health plan resources and forms to assist staff in their day to day functions.
  • Provide resources and training to prior authorization technicians upon completion.
  • Assist Case Management and Concurrent Review staff with complex cases.
  • Assist in reviewing and making revisions to department policies to assure compliance with regulatory agencies.
Qualifications:
  • Unrestricted CA RN or LVN License
  • 3+ Years Prior Authorization Experience in Managed Care
  • Solid communication, organizational and clinical decision-making skills
  • Proficient in MS Office Especially EXCEL
Compensation:
  • Excellent Benefits - Medical, Dental, Vision, paid time off
  • Competitive Salary
HOW TO APPLY:
Interested in this position? We're interested in you! Please apply by clicking either "Apply " at the top of the page. If there is a problem with the link, please email your resumes along with the job title to careers@rcmt.com today!
r