🛠 Tech Stack

💼 About This Role

You'll review prior authorizations for treatments, medications, and procedures to ensure alignment with coverage policies and medical necessity criteria. You'll collaborate with providers, patients, and health plans to facilitate the authorization process. This role offers the opportunity to work from home while making a direct impact on healthcare accessibility.

🎯 What You'll Do

• Evaluate and process prior authorization requests using clinical guidelines
• Assess medical necessity and appropriateness of requested services
• Act as liaison between healthcare providers, patients, and health plans
• Document all authorization activities in EMR systems

📋 Requirements

• Active LVN/LPN license in California
• 2-3 years clinical nursing experience
• 1+ year in utilization review or case management
• Proficiency in EMR systems and prior authorization platforms

✨ Nice to Have

• Certified Professional in Utilization Review (CPUR)
• Certified Case Manager (CCM)
• Managed care experience with medical necessity reviews

🎁 Benefits & Perks

• 💰 Hourly pay $27.10-$40.65
• 🏥 Health benefits including life and disability
• 📈 401(k) savings plan with match
• 🏖️ Paid Time Off and paid holidays

📨 Hiring Process

Estimated timeline: 1-2 weeks · AI estimate

1. 1Recruiter screen· 30 min
2. 2Hiring manager interview· 45 min
3. 3Offer· N/A