Description:

Responsible and accountable for coordination of services for Mercy Medical Group and

Woodland Clinic Medical Group through an interdisciplinary process that provides a clinical and financial

approach through the continuum of care. Promotes the quality and cost effectiveness of medical care by

ensuring department staff are applying clinical acumen and the appropriate application of policies and

guidelines to Managed Care prior authorization referral requests. Under general supervision, this

position is responsible for coordinating the daily operations of the UM Pre-Authorization team in order to

ensure requests are processed in a consistent and timely manner while observing regulatory guidelines.

Responsible for day to day operations of the Pre-Authorization team to include timely response and appropriate

evaluation of referral reviews, correct selection of criteria, accurate prep to the UM Physician reviewer when indicated,

timely verbal and written documentation, and completion of the file

Skills:

Utilization review, Case management, Acute care, Prior authorization, Interqual, Concurrent review, Discharge planning, Epic

Additional Skills & Qualifications:

CA RN License

Five or more year's clinical experience required. Three to five years Utilization Management experience required. One to three years charge/lead/supervisory/management experience required. Ablility to demonstrate leadership and management

skills.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent

• Maintaining an inclusive environment through persistent self-reflection

• Building a culture of care, engagement, and recognition with clear outcomes

• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.