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Clinical - Clinical Review Nurse - Prior Authorization

Pyramid Consulting, Inc Austin, TX (Onsite) Contractor
Immediate need for a talented Clinical - Clinical Review Nurse - Prior Authorization . This is a 06+ Months Contract opportunity with long-term potential and is located in TX (Remote-CST). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-84889

Pay Range: $35 - $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:
  • Shift Time & Working Days: Training will be handled at the team level,
  • Alternate schedule 10am – 7pm Training – 4-5 weeks
  • 8AM – 5PM CST (No days off) CAMERA ON
  • Shift 10 AM-7PM CST - 1 hour lunch
    Day to day will include performing clinical reviews for prior authorization requests utilizing policies, Interqual, sending to the MD if needed.
  • Additionally, will assist with out of network requests and redirecting to in network providers as needed.
  • Performance expectations will include completing at least 20 clinical reviews per day and if assisting with out of network requests will perform 2 redirections per hour
  • This role is unique as it supports Marketplace expansion for Texas
Key Requirements and Technology Experience:
  • Skills-Prior Auth, RN, Utilization review.
  • 2-4 years of experience,
  •  LVN
  • Adaptable to change
  • quick processing, critical thinking
  • well organized
  • ADN, BSN - Requires Graduate from an Accredited School of Nursing or bachelor’s degree in nursing and 2 – 4 years of related experience
  •  RN
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.
 
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.

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Job Snapshot

Employee Type

Contractor

Location

Austin, TX (Onsite)

Job Type

Health Care

Experience

Not Specified

Date Posted

09/10/2025

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