RN Prior Authorization Nurse

Healthcare Support Staffing; Tacoma (WA); On-site; USD 64,000 - 78,000; Full time

Benefits offered by this job

Competitive salary

Annual bonus

Medical benefits

401k Matching

Positive work environment

Job summary

A national healthcare staffing firm is seeking an RN for a position focused on prior authorizations in Tacoma, WA. This role involves reviewing authorization requests, collaborating with care teams, and educating providers on utilization processes. The ideal candidate will possess an RN license and 2-5 years of clinical experience. The position offers a competitive salary between $64-78K and benefits including 401k matching. A positive work environment with opportunities for growth awaits.

Qualifications

• RN license required.
• Minimum of 2-5 years of clinical experience in an acute setting.
• Must have experience authorizing services or calling in for authorizations.
• Knowledge of managed care principles is essential.

Responsibilities

• Promote the quality and cost effectiveness of medical care by applying clinical acumen.
• Perform telephonic review of prior authorization requests.
• Collaborate with staff to coordinate member care.
• Educate providers on utilization processes.

Skills

Clinical experience

Knowledge of utilization management

Comfortable with software

Education

Associate’s degree in Nursing

Job description

Job Description

Daily Responsibilities Prior Auth RN:

• Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests.
• Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations.
• Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings.
• Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care.
• Educate providers on utilization and medical management processes.
• Provide clinical knowledge and act as a clinical resource to non-clinical team staff.
• Enter and maintain pertinent clinical information in various medical management systems.

Qualifications

Requirements RN Prior Authorizations:

• RN license
• Associate’s degree in Nursing.
• Minimum of 2-5 years of clinical experience in acute setting
• Experience authorizing services or experience calling in for auths from a provider setting
• Knowledge of utilization management principles and managed care.
• Must be comfortable with computers and with learning software programs

Hours for this Position

M-F 8-5:30

Advantages of this Opportunity

• Competitive salary ($64-78K) plus annual bonus
• Fun and positive work environment
• Room for growth
• Medical benefits 1st of the month after hire
• 401k Matching

Additional Information

If you are interested in being considered for the position, please contact Ashley Greene at 407‑478‑0332 ext 169.