Job Description

Job Description

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

Job ID: 25-74605

Pay Range: $37 - $39/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
• Prior authorization
• 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
• Required: 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.

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