Prior Authorization Clinical Team reputed company

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company reputed company reputed company is accountable to leadership to support the day to day operations of reputed company. This position has no supervisory reputed company of staff, but requires a solid understanding of the workflows, policies and procedures to ensure reputed company is producing at a successful level. reputed company reputed company supports the reputed company of new staff as reputed company as reputed company monitoring and assignment triage. reputed company reputed company is a single reputed company and first line of contact for staff for clinical issues. They may reputed company reputed company as assigned. reputed company reputed company provides ongoing communication and updates to leadership and contributes and participates in team meetings. The role requires promoting cooperation and team-building between reputed company department members. reputed company reputed company will: - Serve as expert in contractual regulations. - Serve as a content model expert and mentor to reputed company regarding reputed company reputed company, reputed company of interventions, problem reputed company and critical thinking. - Ensure adherence to plan sponsor performance targets. - Implement and support program policies and procedures. - Utilize critical thinking skills to reputed company the level of team performance. - Training - Mentor reputed company, monitoring and providing feedback regarding performance relative to best practices; - New-hires: Request reputed company, plan orientation, schedule CORE training, train new-hires, reputed company reputed company audits on work completed, orient to UM, state contract requirements, Desktops/Job Aids, TAT, productivity goals, and serve as mentor after training completed - reputed company as a role model for the reputed company values, particularly regarding company policies on confidentiality. - Communicate effectively with a reputed company of audiences. - reputed company organized and reputed company to prioritize tasks. - Support a reputed company work environment that promotes the concept of teamwork. - Support to Supervisors as directed. - May have responsibility for their own caseload work. - Respond to issues and inquiries as needed. - Collaborate with other market Team Leads on shared reputed company - Complete reputed company audits on new hires per policy and quarterly as assigned - Assist manager with other tasks as assigned including PTO calendar and holiday schedule - Be on leadership on-call schedule for weekends - Assists with High Dollar Case reporting and presentation - Attend meetings reputed company the manager is unable to attend - Coordinates assistance with other states and departments as needed Required Qualifications reputed company unrestricted RN licensure in Louisiana. 2 or more years clinical and managed care experience required Requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Preferred Qualifications

Ability to mentor and support staff to meet business needs Exceptional communication skills Time efficient and highly organized 2 or more years experience with performance improvement reputed company Performance Improvement and reputed company Improvement (PIP/QIP) experience required Education Bachelor’s degree preferred, Associates in Nursing required. Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $54,095.00 - $116,760.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 06/07/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job