UM Nurse/Prior Auth Nurse

Pyramid Consulting, a global leader in workforce and technology solutions, empowers individuals and organizations to transform and thrive in the most challenging and competitive markets. Pyramid Consulting’s award-winning family of brands – Pyramid Talent, Celsior, and GenSpark– operate together to deliver seamless and integrated solutions which benefit our clients and the consultants who serve them. Through the ‘intentionally inclusive’ recruitment of uniquely qualified candidates and teams; the training and upskilling of recent college graduates and organizational talent; and the customized development and management of innovative technology solutions and teams, Pyramid Consulting proves its lasting commitment to the sustainable growth and success of its consultants and clients. Founded in 1996 and headquartered in Atlanta, Pyramid Consulting serves over 125 Fortune 500 companies across most industries with more than 6500 consultants in 25 countries.

Immediate need for a talented UM Nurse/Prior Auth Nurse. This is a 06+months contract opportunity with long-term potential and is located in Phoenix, AZ (Remote). Please review the job description below and contact me ASAP if you are interested.

Nurses review case files, add, update or edit authorizations. Work closely with the MD team to make final decisions on cases. The clinical team works closely with their supervisors and senior clinicians on the team for support. Team does have group chats on Teams for routine questions. Team works closely together along with the coordinator team who owns end to end process on cases. Team handles various types of authorization and claim review requests from various markets nationwide. Processing clinical reviews to ensure members have the best outcomes and access to care needed. Help reduce provider abrasion by processing retrospective claim reviews.