Utilization Management RN - Prior Authorization
Pyramid Consulting
2 days ago
Contract
Remote
United States
$38 - $40 USD hourly
Utilization Management
Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID:26-31179
Pay Range: $38 - $40/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here.
#prof
Job ID:26-31179
Pay Range: $38 - $40/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:
- Prioritize assigned cases based on urgency and turnaround time.
- Review clinical records against applicable criteria and benefits, documenting findings accurately.
- Communicate requests for missing information and escalate cases outside nursing authority.
- Participate in team huddles, respond to inquiries, and complete administrative tasks.
- Measure performance through quality and documentation accuracy, productivity, and adherence to policies.
- Required: Graduate from an Accredited School of Nursing or bachelor’s degree in nursing.
- 2+ years of clinical nursing experience; experience in utilization management, managed care, or prior authorization is preferred.
- Required: Active RN licensure.
- Strong critical thinking, organization, attention to detail, and professional communication skills.
- Proficiency with electronic clinical systems, Microsoft Office, and remote collaboration tools.
- Experience in case management within required turnaround times.
- Familiarity with medical-necessity criteria and clinical documentation standards.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here.
#prof