Public Health Nursing Consultant - Prior Authorization and Utilization Review

Employer Industry : Healthcare

Why consider this job opportunity : - Salary up to $71,032 - Opportunity for career advancement and growth within the organization - Flexible remote work options available - Comprehensive benefits package including paid holidays, vacation, and sick leave - Top-ranked retirement program with lifetime pension benefits - Supportive work environment focused on employee engagement and satisfaction

What to Expect (Job Responsibilities) : - Monitor, evaluate, and approve or deny payment for medical and behavioral healthcare services - Collaborate with providers and staff regarding care coordination and utilization review - Provide education and technical assistance to healthcare providers to improve compliance - Track and perform reviews for compliance related to utilization management processes - Participate in process improvement initiatives and special projects to enhance efficiency

What is Required (Qualifications) : - Current license to practice as a registered nurse in the State of Arizona - Minimum of three (3) years of relevant experience in healthcare - Understanding of healthcare delivery systems and utilization review principles - Proficiency in oral and written communication - Intermediate computer skills for data retrieval and input

How to Stand Out (Preferred Qualifications) : - Professional experience in the Healthcare Industry, specifically in Prior Authorization and Utilization Management - Familiarity with ICD-9 / 10 Diagnosis Coding and CPT procedure coding - Experience working with diverse populations and understanding cultural influences on behavior

Healthcare #Nursing #RemoteWork #CareerOpportunity #EmployeeBenefits

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