What are the responsibilities and job description for the UM Prior Authorization Nurse (In office or remote) position at Thrifty Management Services, Inc.?
A people-centric culture that values collaboration and work-life balance. If you are enthusiastic about helping those in need, then your enthusiasm is welcomed here.
To Apply see attached link.
The UM Prior Authorization Nurse is primarily responsible for reviewing referrals for medical services to determine medical necessity and course of action, by using their independent judgement and extensive knowledge of medicine, along with clinical guidelines. The UM Prior Authorization Nurse confers with Nursing Manager, VP of Clinical Policy and/or Medical Director whenever appropriate in utilization management or problem solving.
Skill & Experience Requirements
- Bachelor’s or Associate Degree in Nursing (Bachelor’s preferred)
- Current CA State licensure as Registered Nurse (RN) or Licensed Vocation Nurse (LVN)
- At least 2 years of experience in a comparable position.
- Prior authorization or Managed Care experience preferred.
- Must have ability to pay close attention to all details in medical records and clinical guidelines.
Physical Demands/Work Environment
- Must be able to work in a seated position for long periods of time.
- Must be able to use fingers, hands and arms at computer keyboard for long periods of time.
Note: Qualified applicants with arrest or conviction records will be considered for employment with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
Company Overview
Thrifty Management Services is the dedicated MSO for Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members. TMS works with the network’s participating physicians to coordinate patient care. Provide high quality services to its participating physicians and superior health care to its members.
Apply
Email resume to Tatevik Arakelian tarakelian@electronichealthplans.com
Job Type: Full-time
Pay: $70,000.00 - $92,500.00 per year
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible schedule
- Flexible spending account
- Free parking
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Education:
- Bachelor's (Preferred)
Experience:
- Nursing administration: 2 years (Preferred)
License/Certification:
- RN or LVN License (Required)
Shift availability:
- Day Shift (Preferred)
- Overnight Shift (Preferred)
Ability to Commute:
- Chatsworth, CA 91311 (Preferred)
Work Location: Hybrid remote in Chatsworth, CA 91311
Salary : $70,000 - $92,500