Registered Nurse II - Prior Authorization and Referral

We need to output HTML fragment with sections only if real content. Use

for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We must not repeat job title. We must include sections only if posting has real specific content. Let's extract content. Job description includes "Who We Are" and "What We Want". Could map to "About the role". Provide paragraph(s). Then responsibilities list: many bullet points under Prior Authorizations & Care Coordination, Referral Management, Staff Supervision and Leadership, Patient Care and Education, Clinical Operations, Resourcing and Quality Improvement. We'll combine into a single

list of duties? The instruction: Use
• for any list of duties/requirements/benefits. So we can list each bullet as
• . Could group but still list. Qualifications: Required Education & Experience, Required Licenses and Certifications, Preferred Qualifications. That's qualifications section. Knowledge, Skills, and Abilities: that's skills section. Benefits: The posting lists benefits under "Why Texas A&M University?" includes medical, prescription drug, dental, vision, life and AD&D, flexible spending accounts, long-term disability insurance, 12-15 days of annual paid holidays, up to eight hours of paid sick leave and at least eight hours of paid vacation each month, automatic enrollment in Teacher Retirement System, Health and Wellness: Free exercise programs and release time, Professional Development: free LinkedIn Learning training, webinars, limited financial support to attend conferences, Educational release time and tuition assistance, Living Well program. So we have benefits content. Pay: "Proposed Minimum Salary Commensurate" and later "Salary: Commensurate based on selected candidates experience." That's not specific; it's "Commencement based on experience" which is vague. The instruction says: do NOT create Pay/Schedule/Benefits sections unless posting actually states them. For Pay, they say "Proposed Minimum Salary Commensurate" and "Salary: Commensurate based on selected candidates experience." That's not a specific number or range; it's just "commensurate". The instruction: "never emit a heading followed by filler/placeholder text (e.g. 'commensurate with experience', 'not specified', 'N/A', 'varies', 'TBD')". So we should NOT include a Pay section because it's just placeholder. So omit Pay. Schedule: Not mentioned. So omit Schedule. Now we need to include sections: About the role, Responsibilities, Requirements (maybe Qualifications?), Skills, Benefits. The instruction list includes Requirements as a possible heading. We have Qualifications (required education/experience, licenses). Could map to Requirements. Also we have Preferred Qualifications maybe also under Requirements. We'll combine required and preferred under Requirements heading. Skills heading for Knowledge, Skills, and Abilities. Benefits heading for benefits. We must not include Job ID etc. We must preserve all substantive information; do not invent or summarize away detail. So we need to include all bullet points from responsibilities, qualifications, skills, benefits exactly as given (or close). Must not omit any detail. Must not add extra. Let's extract responsibilities bullet points exactly: From text: "Prior Authorizations & Care Coordination - Reviews and processes prior authorizations for medications, radiology procedures, and specialty services. - Navigates payer policies including step therapy protocols, quantity limits, preferred drug lists, and therapeutic substitutions. - Assists patients and providers in identifying and applying for patient assistance programs or financial assistance when available. - Facilitate peer-to-peer reviews with payers when pre-authorizations are denied. - Collaborate with providers to gather necessary clinical documentation and address denials or escalations. - Tracks status of authorizations and manages related communications with patients and staff." "Referral Management - Coordinates external referrals to specialty providers, ensuring completeness of documentation and timely submission. - Follow up with external offices, providers, and students to support continuity of care. - Maintains accurate tracking and communication regarding referral outcomes." "Staff Supervision and Leadership - Supervises designated nursing or medical support staff by managing workload distribution, scheduling, and coverage planning. - Reviews and approves time sheets, time off requests, and ensures coverage meets operational needs. - Provides coaching and timely feedback to support employee development and professional growth. - Participates in performance evaluations alongside the nursing leadership." "Patient Care and Education - Educates patients on referral processes, coverage details, and treatment plans. - Documents clinical and administrative activities in the electronic medical record." "Clinical Operations - Supports day-to-day operations in the clinic, assists in scheduling and patient flow. - Helps ensure compliance with healthcare regulations and university policies. - Assists with the implementation of clinic policies, standards, and procedural updates." "Resourcing and Quality Improvement - Serves as a resource for nursing and administrative staff on prior authorization and referral policies. - Participates in the development and implementation of workflow improvements related to access and coordination of care. - Participates in onboarding and training of new staff, ensuring orientation to clinic protocols and standards. - Represents the nursing team in interdisciplinary meetings or process improvement groups, as needed." We need to preserve bullet points exactly; we can combine into a single
  list with each bullet as
  • . Ensure we keep the wording. Now Qualifications (Requirements): "Required Education & Experience: - Associate Degree in Nursing. - Two years of experience as a Registered Nurse." "Required Licenses and Certifications: - Must be licensed by the State of Texas as a Registered Nurse. - CPR certified." "Preferred Qualifications: - Bachelor's degree in Nursing. - Two years of experience as a Registered Nurse, within the last ten years, including experience in at least one of the following areas: * Prior authorizations or utilization management * Care coordination or case management * Insurance or payer policy navigation * Outpatient clinic operations or referral processing * Reviewing medical documentation for insurance or compliance purposes * Working in a college health, primary care, or ambulatory care setting * Experience spanning multiple areas listed above (e.g., combining prior authorizations with outside medication management, clinic operations, or care coordination). * Experience with direct supervision of employees, performance evaluations, staffing, and/or scheduling." We need to preserve the bullet structure. Could flatten but keep details. We'll produce
    with each item as
    • . For nested items, we could still use
    • and include subtext. Now Skills (Knowledge, Skills, and Abilities): "Knowledge of standard nursing procedures and techniques. Strong understanding of insurance guidelines and prior authorization processes. Ability to review and interpret clinical documentation to determine what is required for prior authorizations and referrals. High level of comfort with computers, databases, and web-based systems; able to independently navigate payer portals, referral platforms, and electronic records systems. Excellent organizational, communication, and problem-solving skills. Ability to multitask and work cooperatively with others. Ability to handle sensitive information and maintain confidentiality. Proficiency in documenting and navigating electronic medical records." Now Benefits: From "Why Texas A&M University?" paragraph: "Medical, prescription drug, dental, vision, life and AD&D, flexible spending accounts, and long-term disability insurance with Texas A&M contributing to employee health and basic life premiums 12-15 days of annual paid holidays Up to eight hours of paid sick leave and at least eight hours of paid vacation each month Automatic enrollment in the Teacher Retirement System of Texas Health and Wellness: Free exercise programs and release time Professional Development: All employees have access to free LinkedIn Learning training, webinars, and limited financial support to attend conferences, workshops, and more Educational release time and tuition assistance for completing a degree while a Texas A&M employee Living Well, a program at Texas A&M that has been built by employees, for employees" We need to preserve as list items. Now About the role: combine "Who We Are" and "What We Want". Let's extract: Who We Are: "University Health Services empowers Texas A&M students through integrated care that supports their physical and mental health. As part of Texas A&M Health—the university’s comprehensive health science center—our clinicians provide the highest level of care in medicine, counseling, psychology and emergency medical services that fosters students’ academic, personal and professional success." What We Want: "The Registered Nurse II- Prior Authorization and Referral, manages the end-to-end administration of prior authorizations and external specialty referrals to ensure patients receive timely, continuous care. This role involves navigating complex payer policies, gathering clinical documentation, managing coverage denials through peer-to-peer reviews, and connecting patients with financial assistance programs. Additionally, the position supports daily clinic operations, educates patients on their coverage and care plans, and serves as a key resource for staff to drive ongoing workflows and quality improvements." We'll combine into a paragraph or two

      elements. Now we must not include any boilerplate like EEO, etc. Already removed. Now produce HTML fragment:

      About the role

      ...

      Responsibilities

      • ...
      ...

      Requirements

      • Associate Degree in Nursing.
      • Two years of experience as a Registered Nurse.
      • Must be licensed by the State of Texas as a Registered Nurse.
      • CPR certified.
      • Bachelor's degree in Nursing.
      • Two years of experience as a Registered Nurse, within the last ten years, including experience in at least one of the following areas: Prior authorizations or utilization management; Care coordination or case management; Insurance or payer policy navigation; Outpatient clinic operations or referral processing; Reviewing medical documentation for insurance or compliance purposes; Working in a college health, primary care, or ambulatory care setting; Experience spanning multiple areas listed above (e.g., combining prior authorizations with outside medication management, clinic operations, or care coordination); Experience with direct supervision of employees, performance evaluations, staffing, and/or scheduling.
      But note we combined preferred qualifications into a single li with semicolons; maybe better to keep each bullet separate. However the instruction says use
      • for any list. We can have nested lists but still each bullet as
      • . Let's break preferred qualifications into separate
      • items. Thus:

        Requirements

        • Associate Degree in Nursing.
        • Two years of experience as a Registered Nurse.
        • Must be licensed by the State of Texas as a Registered Nurse.
        • CPR certified.
        • Bachelor's degree in Nursing.
        • Two years of experience as a Registered Nurse, within the last ten years, including experience in at least one of the following areas:
        • Prior authorizations or utilization management
        • Care coordination or case management
        • Insurance or payer policy navigation
        • Outpatient clinic operations or referral processing
        • Reviewing medical documentation for insurance or compliance purposes
        • Working in a college health, primary care, or ambulatory care setting
        • Experience spanning multiple areas listed above (e.g., combining prior authorizations with outside medication management, clinic operations, or care coordination)
        • Experience with direct supervision of employees, performance evaluations, staffing, and/or scheduling
        But nested
        inside
        • is okay but might be considered extra structure; still fine. Now Skills:

          Skills

          • Knowledge of standard nursing procedures and techniques.
          • Strong understanding of insurance guidelines and prior authorization processes.
          • Ability to review and interpret clinical documentation to determine what is required for prior authorizations and referrals.
          • High level of comfort with computers, databases, and web-based systems; able to independently navigate payer portals, referral platforms, and electronic records systems.
          • Excellent organizational, communication, and problem-solving skills.
          • Ability to multitask and work cooperatively with others.