Posted 3 months ago
Prior Authorization RN
AI Summary
Prior Authorization RN reviews cases for inpatient care, skilled care, acute rehab, and long-term acute care; conducts concurrent prior authorizations per Molina policy, determines benefits and length of stay, and collaborates interdepartmentally for continuity of care.
About this role
Prior Authorization RN
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Interested in being considered?
IF IS JOB OPPORTUNITY IS FOR YOU, GIVE ME A CALL AT 321-574-6926
More Insight of Daily Responsibilities:
Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care
• Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.
• Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
• Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care.
Qualifications
Hospital Utilization Management.
Insurance Utilization Manager/Review. No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience)
Additional Information
Hello!
My name is Krishna Gapuz and I am a Recruiting Consultant with Healthcare Support. I specialize in the placement of medical professionals nationwide (both clinical and non-clinical). We just had an amazing opportunity become available for a Utilization Review RN right in Syracuse, NY (Zip Code 13202). They are looking to start a qualified candidate as quickly as possible (pending hire requirements). This is an amazing opportunity for a Monday – Friday 8:00a.m.-6:00p.m. job with a stable, prestigious company (This Company is one of the leading providers of Healthcare in your area!)
If you would like to be considered for this opportunity please respond to this Email as soon (today) as possible! (or you’re more than welcome to call me at my office 321-574-6926.
If you opt to respond to this Email, please include:
- • Why did you leave your last position and how long ago (or why are you looking to leave your current position)?
- • How much were you last making (hourly)?
- • If offered, how soon could you start?
Skills
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