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Prior Authorization RN

HealthcareSupport Staffing

Long Beach, CAFull-timePosted 11y agoStill listed 3 days ago

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At a glance

Compensation
No compensation found
Location
Long Beach, CA
Schedule
Full-time
Work Authorization
Not specified

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Job overview

HealthcareSupport Staffing is hiring a Prior Authorization RN. The Prior Authorization RN reviews cases for inpatients, including skilled care, acute rehab, and long-term acute care. This role provides concurrent review and prior authorizations according to Molina policy as part of the Utilization Management team. The RN identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and procedures, and participates in interdepartmental integration to enhance continuity of care.

Key focus areas include Review cases for inpatients/in hospital: skilled care, acute rehab and long term acute care, Provide concurrent review and prior authorizations according to Molina policy, and Identify appropriate benefits, eligibility, and expected length of stay for members.

Successful candidates bring Utilization Review Experience 1+ Years and Hospital Experience 3+ Years. Important skills include Utilization Management and Utilization Review. Preferred (not required): Interdepartmental Integration and Collaboration.

Skills & qualifications

RequiredNice to have

Skills

Utilization ManagementUtilization ReviewInterdepartmental IntegrationCollaboration

Qualifications

1+ Year Utilization Review Experience3-4 Years Past Hospital Experience

Full job description

More Insight of Daily Responsibilities:

Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care

  • Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.

  • Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.

  • Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care.

Hospital Utilization Management.

Insurance Utilization Manager/Review. No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience)

Hello!

My name is Krishna Gapuz and I am a R ecruiting Consultant with Healthcare Support . I specialize in the placement of medical professionals nationwide (both clinical and non-clinical). We just had an amazing opportunity become available for a Utilization Review RN right in Syracuse, NY (Zip Code 13202 ). They are looking to start a qualified candidate as quickly as possible (pending hire requirements). This is an amazing opportunity for a Monday – Friday 8:00a.m.-6:00p.m . job with a stable, prestigious company (This Company is one of the leading providers of Healthcare in your area!)

If you would like to be considered for this opportunity please respond to this Email as soon (today) as possible! (or you’re more than welcome to call me at my office 321-574-6926.

If you opt to respond to this Email, please include:

  • • Why did you leave your last position and how long ago (or why are you looking to leave your current position)?
  • • How much were you last making (hourly)?
  • • If offered, how soon could you start?

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