RN Medical Management

About the role

This is a desk-based role focusing on prior authorization. You will review cases using clinical guidelines, collaborate with providers, and document prior auth activities to support quality outcomes and cost-effective care.

Responsibilities

• Frequent use of Microsoft Outlook, Teams and Word
• Participation in meetings
• Independent case reviews

Requirements

• Experience in prior authorization or utilization management
• Experience using CareWebQI/InterQual
• Strong clinical background
• Comfortable working in a remote environment

Qualifications

• Licensed and resides in the state of Arizona
• Registered Nurse (R.N.) licensure in the state of practice
• Bachelor’s degree or equivalent experience
• Five years of clinical experience
• Proficiency in care management, acute care, and/or home care environments
• Critical thinking skills, problem-solving abilities, effective communication skills, and time management skills
• Ability to work effectively in an interdisciplinary team format
• Flexible hours and willingness to take rotating call after hours

Skills

• Microsoft Office Suite
• Outlook, Teams, and Word
• Collaboration with providers
• Case management
• Utilization management
• Quality assurance

Benefits

Not specified

Pay

$35.43 - $59.05 / hour

Schedule

Monday-Friday 8:00AM- 5:00PM AZ TIME WITH ROTATING WEEKENDS EVERY 8TH SATURDAY