Blue

Supervsior- Prior Authorization- Hybrid

Blue(1 month ago)

HybridFull TimeManager$112,652 - $148,070 (estimated)Utilization Management / Prior Authorization
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About this role

The RN Prior Authorization Supervisor oversees the daily operations of the prior authorization team for the Medicaid segment, including Medicaid, Medicare Advantage/D-SNP, and potentially ACA members. The role ensures clinical and nonclinical staff meet quality, productivity, and regulatory standards while maintaining effective workflows and documentation. This position supports onboarding, training, escalation management, and policy oversight within the health plan.

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Required Skills

  • InterQual
  • Documentation
  • Microsoft Excel
  • Communication
  • Clinical Review
  • Medical Necessity
  • Leadership
  • Supervision
  • Utilization Review
  • Prior Authorization

Qualifications

  • High School Diploma or GED
  • Registered Nurse License - Arizona
  • Bachelor of Science in Nursing (Preferred)
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