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Job Requirements of Clinical Review Nurse - Prior Authorization:
-
Employment Type:
Full-Time
-
Location:
Charlotte, NC (Onsite)
Do you meet the requirements for this job?
Clinical Review Nurse - Prior Authorization
Pyramid Consulting, Inc
Charlotte, NC (Onsite)
Full-Time
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:
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy .
#prof J2W:CB3
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.
- 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.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy .
#prof J2W:CB3
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