ElCentroRecruiter Since 2001
the smart solution for El Centro jobs

Prior Authorization Nurse I

Company: Cenpatico
Location: El Centro
Posted on: September 30, 2019

Job Description:

Prior Authorization Nurse I USA-California-El Centro Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests. * Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations * Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings * Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care * Educate providers on utilization and medical management processes * Provide clinical knowledge and act as a clinical resource to non-clinical team staff * Enter and maintain pertinent clinical information in various medical management systems Education/Experience: Graduate from an Accredited School of Nursing. Bachelor s degree in Nursing preferred. 2+ years of clinical nursing experience. Knowledge of healthcare and managed care preferred. Licenses/Certifications: Current State LPN/LVN or RN license. For New Hampshire Healthy Families: Candidates with active nursing licenses in good standing in other states than NH, must obtain the NH equivalent within 90 days of hire. : Active driver s license in good standing preferred. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Clinical & Nursing Full-time

Keywords: Cenpatico, El Centro , Prior Authorization Nurse I, Healthcare , El Centro, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


RN First Surgical Assistant - Travel RNFA
Description: Nationwide Travel Nurse Jobs - RNFA - RN First Surgical Assistant Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking (more...)
Company: HCEN
Location: La Mesa
Posted on: 10/22/2019

Travel Nurse RN - CVICU - $1,785.00 per week
Description: NurseFly Travel Nursing with Skyline Med Staff Nursing is seeking a cvicu travel nurse for a travel nursing job in La Jolla, California: br br br ul br li Specialty: CVICU br li Title: (more...)
Company: NurseFly Travel Nursing
Location: La Jolla
Posted on: 10/22/2019

#102385 (RN) Registered Nurse - Cancer Center BMT
Description: 102385 RN REGISTERED NURSE - CANCER CENTER BMT br br Filing Deadline: Mon 10/28/2019 br br UCSD Layoff from Career Appointment: Apply by 10/23/19 for consideration with preference for rehire. (more...)
Company: University of California - San Diego Medical Cente
Location: San Diego
Posted on: 10/22/2019


Travel Nurse RN - Pediatrics - $1,599.00 per week
Description: NurseFly Travel Nursing with Mynela Staffing is seeking a pediatrics travel nurse for a travel nursing job in La Mesa, California: br br br ul br li Specialty: Pediatrics br li Title: (more...)
Company: NurseFly Travel Nursing
Location: La Mesa
Posted on: 10/22/2019

Pediatric RN - Registered Nurse
Description: Pediatric RN - Registered Nurse San Diego, CA Start Date: 11/04/2019 Apply online or contact us ASAP for more information on this great opportunity Anders Group is looking for a
Company: Anders Group
Location: San Diego
Posted on: 10/22/2019

Travel Nurse RN - PACU - Post Anesthetic Care - $2,007.00 per week
Description: NurseFly Travel Nursing with Care Team Solutions is seeking a pacu - post anesthetic care travel nurse for a travel nursing job in La Jolla, California: br br br ul br li Specialty: PACU - (more...)
Company: NurseFly Travel Nursing
Location: La Jolla
Posted on: 10/22/2019

Physical Therapist - Travel / Locum Tenen PTs (San Marcos,CA)
Description: Physical Therapist - Travel / Locum Tenen PTs Needed ASAP 8.13 26 week assignments Travel Therapist Jobs AssignmentsThe Travel Therapis Season is here and it shows Physical Therapist are one of the (more...)
Company: HealthCare Traveler Jobs
Location: San Marcos
Posted on: 10/22/2019

EP / Cath Lab Registered Nurses needed ASAP - Travel RN (Vista,CA)
Description: Cath Lab / EP Lab Registered Nurses IAPB ECHMO Needed ASAP 8.13 26 week assignments Travel Registered Nurse Jobs AssignmentsThe Travel Nurse Season is here and it shows Registered Nurses are (more...)
Company: HealthCare Traveler Jobs
Location: Vista
Posted on: 10/22/2019

Dentist - Per Diem
Description: Description: br Under the direction of the Dental Director, serve as a Dentist for NHCare and promote an environment of quality care, teamwork, and professional patient service. Practice dental health (more...)
Company: Neighborhood Healthcare
Location: Escondido
Posted on: 10/22/2019

School Travel OT Needed in Chula Vista, CA
Description: Part-Time Occupational Therapist br Your New Adventure: br Are you an Occupational Therapist passionate about working with children and inspired by making a difference Do you enjoy building therapy (more...)
Company: Preferred Healthcare Staffing
Location: Chula Vista
Posted on: 10/22/2019

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

El Centro RSS job feeds