RN: Prior Authorization & Utilization Management (Hybrid)

Central California Alliance for Health; United States; Híbrido; USD 72.000 - 79.000; A tiempo parcial

Ventajas ofrecidas por este puesto de trabajo

Medical, Dental and Vision Plans

Paid Time Off

401(a) Retirement Plan

457 Deferred Compensation Plan

Hybrid work environment

Descripción de la vacante

Central California Alliance for Health is seeking a registered nurse for a temporary Utilization Management role. The position supports prior authorization processes and UM Care Programs, with a focus on accuracy and regulatory compliance.

The role requires a California RN license, a nursing degree, and knowledge of managed care and CMS guidelines. This temporary assignment offers hybrid work arrangements and variable hours, with potential for extension based on business needs.

Formación

• Bachelor’s degree in Nursing required.
• Current unrestricted California RN license.
• Working knowledge of managed care and CMS guidelines.

Responsabilidades

• Ensure prior authorization reviews meet contract requirements.
• Participate in Utilization Management Care Programs.

Conocimientos

Utilization management

Nursing knowledge

Data interpretation

Policy interpretation

Educación

Bachelor's degree in Nursing

Registered Nurse license (CA)

Herramientas

Excel

PowerPoint

Database software

Descripción del empleo

Central California Alliance for Health is seeking a registered nurse for a temporary Utilization Management role. The position supports prior authorization processes and UM Care Programs, with a focus on accuracy and regulatory compliance.

The role requires a California RN license, a nursing degree, and knowledge of managed care and CMS guidelines. This temporary assignment offers hybrid work arrangements and variable hours, with potential for extension based on business needs.