Prior Authorizations Nurse RN Specialist
4 weeks ago
We are seeking a skilled Prior Authorizations Nurse RN to join our team at Central California Alliance for Health. As a Prior Authorizations Nurse RN, you will play a critical role in ensuring that prior authorization requests are completed in a timely fashion to meet contractual requirements and that all reviews are conducted using nationally recognized and evidence-based standards.
Key Responsibilities:
• Ensure timely completion of prior authorization requests to meet contractual requirements
• Conduct reviews using nationally recognized and evidence-based standards
• Collaborate with healthcare providers to obtain necessary information for reviews
• Develop and maintain knowledge of Milliman Care Guidelines, Medi-Cal and related policy, and Title 22 regulations
Requirements:
• Bachelor's degree in Nursing and a minimum of three years of experience in a patient care setting
• Minimum of one year of experience in Utilization Management or Case Management
• Current unrestricted license as a Registered Nurse issued by the State of California
What We Offer:
• Competitive compensation package
• Ample paid time off and 12 paid holidays per year
• 401(a) Retirement Plan and 457 Deferred Compensation Plan
• Robust Health and Wellness Program and onsite EV charging stations
About Us:
We are a regional non-profit health plan serving members in Mariposa, Merced, Monterey, San Benito, and Santa Cruz counties. We are committed to providing accessible, quality healthcare that is guided by local innovation. If you are a motivated and detail-oriented Prior Authorizations Nurse RN looking for a challenging and rewarding role, please apply today.
-
Pharmacy Authorization Specialist
4 weeks ago
Santa Monica, California, United States UCLA Health Full timeJob SummaryUCLA Health is seeking a highly skilled Pharmacy Authorization Specialist to join our team. As a Pharmacy Authorization Specialist, you will play a critical role in improving patient access to treatment and adherence to medically necessary pharmaceuticals. You will be responsible for managing patient insurance benefits, utilizing established...
-
Pharmacy Authorization Specialist
1 month ago
Santa Monica, California, United States UCLA Health Full timeJob SummaryWe are seeking a highly skilled Pharmacy Authorization Specialist to join our team at UCLA Health. As a key member of our Hematology/Oncology team, you will play a critical role in improving patient access to treatment and adherence to medically necessary pharmaceuticals.Key ResponsibilitiesManage patient insurance benefits and utilize established...
-
Pharmacy Authorization Specialist
1 month ago
Santa Monica, California, United States University of California Full timeJob SummaryWe are seeking a highly skilled Pharmacy Authorization Specialist to join our team at the University of California. In this role, you will play a critical part in improving patient access to treatment and adherence to medically necessary pharmaceuticals by managing patient insurance benefits and utilizing established patient assistance...
-
Pharmacy Technician Authorization Specialist
4 weeks ago
Santa Monica, California, United States UCLA Health Full timeJob Summary:UCLA Health is seeking a highly skilled Pharmacy Technician to fill the role of Authorization Specialist. In this position, you will play a critical role in improving patient access to treatment and adherence to medically necessary pharmaceuticals.Key Responsibilities:Manage patient insurance benefits and utilize established patient assistance...
-
Pharmacy Technician Authorization Specialist
4 weeks ago
Santa Monica, California, United States University of California Full timeJob SummaryThe University of California seeks a highly skilled Pharmacy Technician Authorization Specialist to join our team. In this role, you will play a critical part in improving patient access to treatment and adherence to medically necessary pharmaceuticals by managing patient insurance benefits and utilizing established patient assistance programs.Key...
-
Authorization Specialist
1 month ago
Santa Monica, California, United States UCLA Health Full timeJob SummaryWe are seeking a highly skilled and experienced Authorization Lead Pharmacy Technician to join our team at UCLA Health. This role will play a critical part in improving patient access to treatment and adherence to medically necessary pharmaceuticals.Key ResponsibilitiesManage patient insurance benefits and utilize established patient assistance...
-
Authorization Specialist
4 weeks ago
Santa Monica, California, United States UCLA Health Full timeJob Summary:UCLA Health is seeking a highly skilled Authorization Specialist to join our team. In this role, you will be responsible for obtaining authorization for and scheduling chemotherapy, injections, and procedures within the office, at UCLA facilities, and at outside facilities.Key Responsibilities:Verify insurance benefits for requested procedures...
-
Nurse Specialist
3 weeks ago
Santa Cruz, California, United States Jackson Nurse Professionals Full timeWe are seeking a highly skilled Nurse Specialist to join our team of healthcare professionals. As a Labor and Delivery Nurse, you will provide expert care to mothers and their babies during the delivery process.Key Responsibilities:Provide patient-centered care to laboring mothers and their newborns.Collaborate with a multidisciplinary team to ensure...
-
Travel Nurse RN Specialist
4 weeks ago
Santa Cruz, California, United States TotalMed Staffing Full timeJob Title: Travel Nurse RN SpecialistJob Description:We are seeking a skilled Travel Nurse RN Specialist to join our team. As a Telemetry Nurse, you will be responsible for providing high-quality patient care in a fast-paced hospital setting.Key Responsibilities:Provide direct patient care to patients with various medical conditionsMonitor and interpret...
-
Nurse Specialist
4 weeks ago
Santa Cruz, California, United States Core Medical-Perm Full timeCore Medical-Perm is seeking a skilled Nurse Specialist for a Home Health nursing job in California. The ideal candidate will have at least 1 year of relevant experience in Home Health and be able to work 40 hours per week with an 8-hour shift. The position requires a strong commitment to providing high-quality patient care and a passion for working in a...
-
Travel Nurse RN Position
4 weeks ago
Santa Cruz, California, United States Nurse First Full timeNurse First is seeking a travel nurse RN Maternal - Newborn for a travel nursing job.Job DetailsSpecialty: Maternal - NewbornDiscipline: RNEmployment Type: TravelNurse First Job ID #. Our company's founder was a nurse first, and at our roots, we believe nurses need advocates to help them have the best experience possible.About Nurse FirstWe believe the...
-
Travel Nurse RN Position
4 weeks ago
Santa Cruz, California, United States Nurse First Full timeNurse First is seeking a travel nurse RN Med Surg / Telemetry for a dynamic nursing opportunity in a reputable healthcare facility.Job DetailsSpecialty: Med Surg / TelemetryDiscipline: RNDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelNurse First offers a competitive pay package based on 12 hour shifts and 36 hours per week,...
-
Travel Nurse RN Position
4 weeks ago
Santa Cruz, California, United States Nurse First Full timeNurse First is seeking a travel nurse RN for a CVICU position in California.Job DetailsSpecialty: CVICUDiscipline: RNDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelNurse First Job ID #52400772. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be...
-
Travel Nurse RN Position
4 weeks ago
Santa Cruz, California, United States Nurse First Full timeNurse First Travel Agency is seeking a skilled CVICU travel nurse RN for a 13-week assignment in California. The position offers a tax-free stipend and a competitive pay package based on 12-hour shifts and 36 hours per week.The ideal candidate will have experience working in a CVICU setting and be able to provide high-quality patient care. Benefits include...
-
Travel Nurse RN Position
4 weeks ago
Santa Cruz, California, United States Jackson Nurse Professionals Full timeJackson Nurse Professionals is seeking a travel nurse RN for a post partum assignment in a California hospital.Job DetailsSpecialty: Post PartumDiscipline: RNEmployment Type: TravelThe pay package is based on 12 hour shifts and 36 hours per week, with a tax-free stipend amount to be determined.About the AssignmentThis post partum travel nursing assignment is...
-
Travel Nurse RN Specialist
4 weeks ago
Santa Cruz, California, United States Medical Solutions Full timeTravel Nurse RN Specialist OpportunityWe're seeking a skilled Registered Nurse to join our team in Santa Cruz, CA, specializing in Stepdown care. As a travel nurse with Medical Solutions, you'll have access to thousands of high-paying job opportunities across the US, Guam, and Washington D.C.Benefits and Perks$600 Unlimited Loyalty Bonus after 600 hours...
-
Pharmacy Technician
4 weeks ago
Santa Monica, California, United States University of California Full timeJob SummaryWe are seeking a highly skilled Pharmacy Technician to join our team at the University of California. As an Authorization Pharmacy Technician, you will play a critical role in improving patient access to treatment and adherence to medically necessary pharmaceuticals.Key ResponsibilitiesManage patient insurance benefits and utilize established...
-
Travel Nurse RN Position
4 weeks ago
Santa Cruz, California, United States Travel Nurse Across America Full timeWe are seeking a skilled Telemetry RN for a travel nursing position in a dynamic healthcare setting. As a Telemetry RN, you will be responsible for providing high-quality patient care by monitoring and interpreting electronic data from various machines. Your expertise in reading and recording data will enable you to make informed decisions to improve patient...
-
Santa Cruz, California, United States Nurse First Full timeAbout the JobNurse First is seeking a travel nurse RN with expertise in Maternal - Newborn care to join our team in Santa Cruz, California.Key DetailsSpecialty: Maternal - NewbornDiscipline: RNDuration: 13 weeksHours: 36 hours per weekShift: 12 hours, nightsThis role offers an excellent opportunity to gain diverse clinical experience while enjoying the...
-
Travel Nurse RN Position
3 weeks ago
Santa Cruz, California, United States Jackson Nurse Professionals Full timeJackson Nurse Professionals is seeking a travel nurse for a Labor and Delivery position in California.Job DetailsSpecialty: Labor and DeliveryDiscipline: RNEmployment Type: TravelA hospital in California requires an experienced Women's Services Interim Manager for a travel assignment. The ideal candidate will have 2+ years of experience, hold an active BLS,...