Prior Auth Nurse

Pyramid Consulting, Inc; Ohio; Remote; Full time

Job summary

Pyramid Consulting, Inc is seeking a Prior Auth Nurse for a remote 6+ months contract role based in Ohio. The role entails analyzing prior authorization requests, requiring a nursing degree and licensing, with a strong emphasis on medical knowledge and effective care management. Competitive pay is offered in a supportive healthcare environment.

Benefits

Health insurance (medical, dental, vision)

401(k) plan

Paid sick leave

Qualifications

• Requires Nursing Licensure.
• 2 - 4 years of related nursing experience.
• Experience in prior authorization and clinical nursing is preferred.

Responsibilities

• Analyze prior authorization requests for medical necessity.
• Make recommendations to promote quality medical care.

Skills

Care manager

Medical knowledge

Computer skills

Education

Graduate from an Accredited School of Nursing

Job description

Pyramid Consulting, Inc provided pay range

This range is provided by Pyramid Consulting, Inc. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$36.00/hr - $40.00/hr

Immediate need for a talented Prior Auth Nurse. This is a 06+months contract opportunity with long-term potential and is located in Ohio (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-75553

Pay Range: $36 - $40/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:

• Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage.
• Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.

Key Requirements and Technology Experience:

• Key Skills; Care manager
• Medical knowledge
• Computer skills, medical knowledge,
• Care manager or clinical nursing experience
• Works well for this role: Prior Authorization Nurse, Medical Review Nurse, Appeals Nurse, Utilization Management or Quality Assurance Nurse
• Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience.
• Required: Nursing Licensure

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.

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 here.

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Contract

Job function

• Job function

  Information Technology

• Industries

  Hospitals and Health Care

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