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Prior Authorization RN

Pyramid Consulting, Inc

New York, NY(remote)

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JOB DETAILS
SALARY
$39–$41 Per Hour
SKILLS
Artificial Intelligence (AI), Clinical Competency, Clinical Nursing, Clinical Practices/Protocols, Clinical Study Publications, Consulting, Documentation, Employee Benefits, Insurance, Nursing, Nursing Credentials, Operating Room Nursing, Registered Nurse (RN), Short Messaging Service (SMS), Utilization Management
LOCATION
New York, NY(remote)
POSTED
3 days ago
Immediate need for a talented Prior Authorization RN . This is a 03+months contract (Possible extension OR conversion) opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-20465

Pay Range: $39 - $41/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:
  • We are seeking a Clinical Review Nurse – Prior Authorization (RN) to perform medical necessity reviews and prior authorization determinations in accordance with clinical guidelines.
  • The role involves reviewing authorization requests, documenting in Facets, coordinating with providers, conducting member/provider outreach, and applying MCG/InterQual criteria.
  • This is a 100% remote.
Key Requirements and Technology Experience:
  • Must have skills: - "Prior Authorization", "Utilization Management", "Medical Necessity Review" , "Registered Nurse".
  • Requires Graduate from an Accredited School of Nursing OR Bachelor’s degree in Nursing AND 2 – 4 years of related experience.
  • Licensure: RN
  • Candidates should have 2–4 years of prior authorization/utilization management experience, strong clinical documentation skills, and experience in a payer or insurance environment.
Our client is a leading MCOIndustry, 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.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
 
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Pyramid Consulting, Inc

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