Clinical Review Nurse - Prior Authorization

Immediate need for a talented Clinical Review Nurse - Prior Authorization. This is a 03+ Months Contract opportunity with long-term potential and is located in North Carolina(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-63772

Pay Range: $37 - $39/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities:
 

• This role is for M-F 8a-5pEST clinical review nurse prior authorization.
• As a member of this team you will review medical records, collaborate with other disciplines within our plan, and rely primarily on state Medicaid policy to clinically review outpatient medical prior authorization requests from providers to better serve our members and their individual health needs.
• We have a very tight knit team that has worked together for many years and is always welcoming and helpful in precepting and guiding any new hire we bring on.
• We communicate daily, answering questions for each other and providing support where needed in our team groupchat.
• We also have 3 senior nurses and 1 team lead ready and available to assist with day to day questions and process concerns as you learn your new role and systems.
• Each nurse receives an assignment each morning, and the expectation for daily productivity is to complete >=16 authorizations, which is about 2 per hour.

Key Requirements and Technology Experience:

• Skills-"PRIOR AUTHORIZATION", "CLINICAL REVIEW" and "UTILIZATION REVIEW".
• 1+ years of Utilization Management experience.
• 1+ years of Prior Authorization experience with TruCare MCG or Interqual.
• 3+ years of Nursing experience. 

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
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