RN Case Manager - Prior Authorization

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Position Purpose: Review requests for contract specific prior authorization of services within a centralized unit

• Review provider request for contract specific prior authorization through fax or telephone with application of evidence based criteria to ensure medical necessity for services
• Act as clinical resource to unit referral specialist staff and make appropriate referrals
• Provide provider education as directed
•  Data entry and inquiry using both claims and clinical system software for performance of the authorization review process with documentation into the appropriate systems

• Active OH RN Licensure
• Experienced with either Interqual or Milliman

Advantages of this Opportunity:

• Hours for this Position: Monday- Friday 8a-5p

• Pay $30.00 per hour

• Start date: 7/6

If you are interested, please call, Lovely 321-574-6539 and email your resume to me.

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If you know of someone looking for a new opportunity, please pass along my contact information! We offer referral bonuses of up to $100.00 for each placement.