Location: Covina, CA
teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success. We currently have an opening for a Prior Authorization Case Manager: The role of the Prior Authorization Nurse Case Manager (PACM) is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization specialty referral requests.
The PACM will review for appropriate care and setting, and following guidelines/policies, will approve services when indicated. If not indicated, PACM will forward requests to the appropriate physician
or medical director with recommendations for other determinations, ensuring that the member is receiving the appropriate quality care in a preferred setting, while making sure regulatory guidelines are followed.
We offer a full benefits package which includes employer paid medical, shop and dental benefits. We offer a generous PTO package, 401k Retirement Savings, Life Insurance, Flexible Spending Account (FSA), Tuition Reimbursement & Licensed Renewal Fees for our clinical staff. For more details: jobs-search. org/insurance_covina-c426283/prior-authorization-nurse-lvnrn-covina_i1949639833
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