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Um Prior Auth Nurse
4 months ago
Utilizes decision-making and critical-thinking skills in the clinical review and determination of coverage for medically necessary health care services based on established hierarchy of criteria
Knowledge of California Children Services (CCS)
Knowledge of Health Plan DOFR's
Maintain Compliance and CMS regulatory standards
Follow UM Policies & Procedures
Experience in Healthcare/Managed Care
Work closely with UM team and Medical Director
LVN/RN Lic
2 Year Min in Managed Care
Pay: From $36.00 per hour
Expected hours: 40 per week
**Benefits**:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Physical setting:
- Outpatient
**Education**:
- Bachelor's (preferred)
**Experience**:
- Nursing: 3 years (required)
License/Certification:
- BLS Certification (preferred)
- RN OR LVN (required)
Work Location: In person
