Pre-Authorization Registered Nurse

Required Qualifications – What it takes to Succeed Licensed Registered Nurse (RN) in the state of Kentucky with no disciplinary action and ability to hold licenses in multiple states without restriction Minimum 3 years of experience as a nurse in a clinical setting Strong Proficiency with MS Office Suite Word, Excel, Power Point and ability to learn multiple systems Experience with the development and implementation of policies and procedures Preferred Qualifications: Bachelor's Degree Health Plan experience working with large carriers Previous Medicare/Medicaid experience a plus Previous experience in utilization management, case management, discharge planning and/or home health or rehab Experience working with MCG and HCG guidelines Workstyle: Remote Work at Home Location: Must reside within a 2-hour driving distance of Louisville, Kentucky office to attend meetings and trainings as needed Schedule: Must be available Monday-Friday 9:00 AM - 6:00 PM Eastern Time with very limited rotating on-call coverage and oversight during weekends and holidays. Travel: Meet quarterly in Louisville office for meetings Work At Home Requirements: WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

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