UM Prior Authorization Nurse, RN (Work from Home)

NeueHealth(11 months ago)

California, United StatesOnsiteFull TimeMedior$74,260.46 - $111,390.7Utilization Management

About this role

The Utilization Management Prior Authorization Nurse at NeueHealth is a full-time clinical role focused on ensuring appropriate benefit coverage and quality outcomes for the designated population. The position supports value-driven care by collaborating with Medical Directors, clinical teams, providers, patients, and health plans. The role requires adherence to organizational policies and regulatory standards while contributing to utilization monitoring and quality initiatives.

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Required Skills

Prior Authorization
Utilization Management
Clinical Assessment
Medical Necessity
Eligibility Verification
Provider Liaison
Patient Communication
Documentation
Regulatory Compliance
Quality Improvement

+5 more

Qualifications

Active California RN License
BSN (Preferred)
CMCN (Preferred)

About NeueHealth

neuehealth.com

NeueHealth is a tech-enabled healthcare company focused on making care more personal, accessible, and affordable. Through its operating businesses — including NeueCare, NeueSolutions, and an ACO — it provides integrated care delivery, value‑based care programs, and operational and technology services for providers and payors. NeueHealth serves health systems, clinicians, payors, and consumers with solutions designed to simplify access, improve outcomes, and lower costs.