Temporary Prior Authorizations Nurse (RN)

ABOUT THIS TEMP POSITION

This is a temporary position and the length of the assignment is always dependent on business needs and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with.

WHAT YOU'LL BE RESPONSIBLE FOR

Ensure that prior authorization requests are completed in a timely fashion to meet contractual requirements and that all reviews are conducted using nationally recognized and evidence-based standards

WHAT YOU'LL NEED TO BE SUCCESSFUL

• Knowledge of:
• Current working knowledge of Milliman Care Guidelines in review determination process
• Medi-Cal and related policy and Title 22 regulations
• utilization management principles and activities
• case management principles and activities
• Ability to:
  • understand concepts pertaining to prepaid health care
  • demonstrate strong critical thinking and clinical nursing skills
  • use MS Word
  • evaluate medical records and other health care data
• Education and Experience:
  • Bachelor’s degree in Nursing and a minimum of three years of experience in a patient care setting which included a minimum of one year of experience in Utilization Management or Case Management; or an equivalent combination of education and experience may be qualifying
  • Current unrestricted license as a Registered Nurse issued by the State of California

To read the full position description, and list of requirements click here. 

OTHER DETAILS

• While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
• Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
• Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process
• This is a temporary position, and does not provide the benefits that are listed below (it is standard language from our regular job posts and cannot be altered or removed)