Prior Authorization Nurse

HealthcareSupport Staffing is hiring a Prior Authorization Nurse. The Prior Authorization Nurse reviews cases for inpatients, including skilled care, acute rehab, and long-term acute care. This role provides concurrent review and prior authorizations as needed, adhering to Molina policy for Molina members within the Utilization Management team. The nurse identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments or procedures, and collaborates with interdepartmental teams 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 (as needed) according to Molina policy for Molina members as part of the Utilization Management team, and Identify appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.

Preferred (not required): Concurrent Review, Prior Authorizations, Utilization Management, and Interdepartmental Integration.