Prior Authorization Nurse
at RCM Health Care Services

Date Posted: 4/2/2019

Job Description

Established Health Plan with a close knit, family feel office environment is seeking an Prior Authorization Nurse in Canoga Park, CA.

Prior Authorization Nurse

Job Summary:
  • Perform clinical review of requests requiring medical review and entering authorizations into the system.
  • Clearly and accurately document on rational for approving request or reason for sending to the Medical Director for additional review.
  • Handle telephone requests timely and accurately.
  • Develop and update health plan resources and forms to assist staff in their day to day functions.
  • Provide resources and training to prior authorization technicians upon completion.
  • Assist Case Management and Concurrent Review staff with complex cases.
  • Assist in reviewing and making revisions to department policies to assure compliance with regulatory agencies.
  • Unrestricted CA RN or LVN License
  • 3+ Years Prior Authorization Experience in Managed Care
  • Solid communication, organizational and clinical decision-making skills
  • Proficient in MS Office Especially EXCEL
  • Excellent Benefits - Medical, Dental, Vision, paid time off
  • Competitive Salary
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Job Snapshot

About Us

RCM Health Care Services offers career defining opportunities to candidates from the leading employers in health care. Whether you’re looking for a new job or seeking to hire the best medical talent, RCM Health Care Services has the solution for you. Since 1975, we’ve established ourselves as a leader in the recruitment industry by connecting thousands of healthcare professionals with placements that support their needs. If you’re looking to make the next move in your career, let RCM be your guide, we’re with you every step of the way!

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