Rn Medical Management Services

Banner Medical Group

Arizona, United States
Base: $35.43 - $59.05 ph; bonus/equity: not specif...
Fully remote
Prior authorization experience required
Proficiency with cms and mcg guidelines
Strong critical thinking and problem-solving skills
Banner Medical Group is seeking an RN for Medical Management Services, focusing on prior authorization and care coordination in a fully remote role. The ideal candidate should have a strong clinical background, experience in care management, and possess a Registered Nurse license in Arizona

Job Summary

  • This role involves reviewing medical plans and making prior authorization determinations using tools like CMS and Noridian.
  • Banner Health is recognized as one of the top places to work in healthcare and offers a comprehensive total rewards package.
  • The position requires managing patient care across the continuum to achieve optimal clinical and financial outcomes while adhering to federal regulations.

Matching Summary

Match Score: 85

Banner Medical Group is seeking an RN for Medical Management Services, focusing on prior authorization and care coordination in a fully remote role. The ideal candidate should have a strong clinical background, experience in care management, and possess a Registered Nurse license in Arizona.

Salary

Base: $35.43 - $59.05 per hour; Bonus/Equity: Not specified; Benefits: Comprehensive health, financial security, and wellness options included

Skills & Requirements

Must-have

  • Prior authorization experience required
  • Proficiency with CMS and MCG guidelines
  • Strong critical thinking and problem-solving skills
  • Ability to work rotating Saturday shifts
  • Must reside in Arizona state

Nice-to-have

  • Experience with Optum360 Encoder Pro tool
  • Background in acute or home care environments
  • Collaborative interdisciplinary team approach
  • Flexible availability for after-hours call rotation

Key Requirements

  • Active Registered Nurse (R.N.) licensure
  • Bachelor's degree or equivalent experience
  • Five years of relevant clinical experience
  • Knowledge of care management and utilization management
  • Certification in Managed Care Nursing preferred

Work Rights

Must reside in AZ

Tailored Resume

Cover Letter