Prior Authorization Nurse Specialist Healthcare Professional

2 weeks ago


Rockledge, Florida, United States Health First Full time

Job Title: Prior Authorization Nurse Specialist

We are seeking a skilled and detail-oriented Prior Authorization Nurse Specialist to join our team at Health First. This role will be responsible for reviewing and processing prior authorization requests in accordance with member contract provisions, medical policies, and departmental procedures.

As a Prior Authorization Nurse Specialist, you will play a crucial role in ensuring that healthcare services are delivered in a cost-effective and quality-based manner. You will work closely with physicians, members, vendors, and other internal associates to resolve issues and ensure compliance with regulatory standards and accreditation guidelines.

The ideal candidate will have excellent attention to detail, advanced computer skills, and the ability to communicate effectively with various stakeholders. A minimum of 2 years' experience in managed care, preferably with Medicare, is required. RN or LPN licensure in Florida is also mandatory.

This position offers an estimated salary range of $65,000 - $80,000 per year, depending on experience. If you are a motivated and organized individual with a passion for healthcare, we encourage you to apply.



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