Authorization Nurse, Rn - 26-28

Hill Physicians Medical Group

Base: $100,000 - $120,000 annual; bonus/equity: no...
Review authorization requests for medical necessity
Apply icd-10, cpt, and hcpc coding knowledge
Collaborate with medical directors on clinical decisions
The Utilization Management team facilitates the review of requests for medical necessity to assure timely care at the correct level

Job Summary

  • The Utilization Management team facilitates the review of requests for medical necessity to assure timely care at the correct level.
  • Hill Physicians is regularly recognized as one of the 'Best Places to Work in the Bay Area' and values diversity and inclusion.
  • This role requires evaluating authorization requests and finalizing status while collaborating with physicians and meeting regulatory timelines.

Matching Summary

The Utilization Management team facilitates the review of requests for medical necessity to assure timely care at the correct level.

Salary

Base: $100,000 - $120,000 Annual; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Review authorization requests for medical necessity
  • Apply ICD-10, CPT, and HCPC coding knowledge
  • Collaborate with Medical Directors on clinical decisions

Nice-to-have

  • Payor side utilization management experience
  • Delegated model experience preferred
  • Strong organizational skills for fast-paced environment

Key Requirements

  • Current active unrestricted California RN licensure
  • Minimum three years hands-on clinical nursing experience
  • Graduate of an Accredited RN program

Work Rights

Must have California RN license

Tailored Resume

Cover Letter