Medical Prior Authorization Nurse
1 week ago
Humana, Inc. is a leading healthcare company that prioritizes putting health first for its employees, customers, and communities.
About the Role:
We are seeking a highly skilled Medical Prior Authorization Nurse to join our team in Oklahoma. As a key member of our care delivery team, you will play a vital role in ensuring timely and efficient prior authorization processes for patients' medical services.
Job Responsibilities:
The successful candidate will be responsible for reviewing prior authorization requests, applying clinical judgment to determine medical necessity, and collaborating with internal stakeholders to resolve complex cases.
Key Skills and Qualifications:
To excel in this role, you will need:
• Active Registered Nurse (RN) license in the state of Oklahoma
• Minimum 2 years of experience in acute care, emergency room, ICU, or rehabilitation settings
• Strong knowledge of MS Office applications, including Word, Excel, PowerPoint, and Teams
• Excellent communication and problem-solving skills
• Ability to work independently and collaboratively as part of a team
Preferred Qualifications:
While not mandatory, previous experience in prior authorization, utilization management, Medicare/Medicaid, and MCG or Interqual guidelines would be advantageous.
Benefits and Compensation:
As a valued member of our team, you can expect:
• Competitive salary range: $31,200 - $85,100 per year, based on your skills, experience, and qualifications
• Comprehensive benefits package, including paid time off, 401(k) retirement savings plan, employee assistance program, and business travel insurance
About Working at Humana:
We are committed to creating a diverse, inclusive, and equitable work environment where everyone feels valued and supported. Our mission is to make healthcare accessible and affordable for all, and we believe that our team members are the driving force behind achieving this vision.
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