Utilization Management RN Prior Authorization

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12 Months Contract opportunity with long-term potential and is located in US (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-31179

Pay Range: $38 - $40/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:

• Prioritize assigned cases based on urgency and turnaround time.
• Review clinical records against applicable criteria and benefits documenting findings accurately.
• Communicate requests for missing information and escalate cases outside nursing authority.
• Participate in team huddles respond to inquiries and complete administrative tasks.
• Measure performance through quality and documentation accuracy productivity and adherence to policies.

Key Requirements and Technology Experience:

• Required: Graduate from an Accredited School of Nursing or bachelors degree in nursing.
• 2 years of clinical nursing experience; experience in utilization management managed care or prior authorization is preferred.
• Required: Active RN licensure.
• Strong critical thinking organization attention to detail and professional communication skills.
• Proficiency with electronic clinical systems Microsoft Office and remote collaboration tools.
• Experience in case management within required turnaround times.
• Familiarity with medical-necessity criteria and clinical documentation standards.

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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