Part Time Prior Authorizations Nurse (RN) (Temporary) (Fully Remote)

• Ensuring prior authorization requests meet contractual requirements using evidence-based standards.
• Participating in the Utilization Management (UM) Care Programs.
• Evaluating medical records and health care data to apply policies and regulations.

WHAT YOU'LL NEED TO BE SUCCESSFUL:

• Current unrestricted RN license in California and a Bachelor's degree in Nursing.
• Working knowledge of managed care, Medi-Cal, CMS guidelines, and prior authorization principles.
• Proficiency in Microsoft Excel, PowerPoint, and database software.

COMPENSATION:

• Zone 1 pay range: $52 - $57.50 per hour; Zone 2: $49 - $54 per hour.
• Final compensation based on qualifications and geographic location.
• This is a temporary position; benefits not provided.

Central California Alliance for Health

Central California Alliance for Health is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties. We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation.