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RN - Manager, Prior Authorization


RN - Manager, Prior Authorization
Location Phoenix - Maricopa AZ
Compensation
Benefits - Full
Relocation Assistance Available - Possible for ideal candidate
Commission Compensation - No
Bonus Eligible - Yes
Overtime Eligible - No
Interview Travel Reimbursed - No
Job Description
This position is responsible for managing the Care Coordination Department/Prior Authorizations. The individual is responsible for coordinating and delegating the overseeing department production performance standards, reviewing and revising policies and procedures as well as process, attending assigned meetings, managing staff processes consistent with health plan compliance.
This position requires minimum supervision to ensure tasks are appropriately prioritized. The Medical Director provides oversight of all applicable clinical issues. The Director of Medical Services provides oversight over daily operational issues.

Responsible for oversight of the Care Coordination personnel. Ensures the effective processes of Referral Determination, Concurrent Review, Ambulatory Case Management, including, appropriate triage, data entry, coordination and discharge from programs according to existing policy and procedure.
Qualifications:
Light physical effort (lift up to 10lbs). Mostly sedentary work. Regularly needs to be able to bend, stoop and reach to file.

Bachelor's Degree in Nursing required
AZ RN License
2+ yrs. of progressive supervisory experience in Healthcare
5+ yrs. in ambulatory or concurrent case management experience in managed care
5+ yrs. prior authorization management
Experience in EZ-CAP
Willingness to Travel - Occasionally


Keywords: BSN, MSN, RN, Nursing, registered nurse, care coordinator, supervisory, manager, charge nurse, prior authorization, EZ-CAP, ambulatory, healthcare

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