**Experienced Full Stack Prior Authorization Clinical Reviewer – Remote Work Opportunity at arenaflex**

Join arenaflex, a leading healthcare organization, in a unique opportunity to work from home as a Prior Authorization Clinical Reviewer. As a key member of our team, you will play a crucial role in reviewing and authorizing medical services for our clients, ensuring that they receive the best possible care.

• *About arenaflex**

arenaflex is a renowned healthcare organization that has been serving Arizonans since 1985. We provide access to physical and behavioral health services, as well as Medicaid-directed care, to individuals who are eligible for Medicaid. Our team is dedicated to providing high-quality care to our clients, and we are committed to making a positive impact in our community.

• *About the Role**

As a Prior Authorization Clinical Reviewer, you will be responsible for reviewing and authorizing medical services for our clients. This will involve:

• Prior authorization review of physical and behavioral health services
• Utilization of clinical skills to determine, record, and communicate all aspects of the use/benefit management program
• Utilization of critical thinking and data on clinically sound treatment, evidence-based care, and clinical need models for appropriate use of services for individuals with disabilities and special clinical needs
• Accepting provider calls associated with prior authorization questions and making decisions for individuals to advise regarding care confirmation
• Gathering clinical information and applying appropriate clinical need guidelines/rules, techniques, framework, and clinical judgment to convey care authorization/idea/discharge planning along the continuum of care
• Use of clinical experience and skills in a helpful cycle to review and work with legitimate clinical care services/benefits for individuals
• Recognizing confirmation of individuals who could benefit from care management activities and support of the referral
• Recognizing confirmation of opportunities to promote quality adequacy of clinical care services and benefit utilization

• *Required Qualifications**

• 5+ years of clinical experience as an RN
• Must have active and unrestricted RN licensure in the state of Arizona
• Must be willing and able to participate in in-state gatherings occasionally. Reliable transportation is required. Mileage is reimbursed per our organization's cost reimbursement system
• Preferred Qualifications:
+ Prior Utilization Management experience+ Strong critical thinking and made social skills

• *Guidance**

• Long-term affirmation in Nursing is required

• *About the Work Environment**

As a remote worker, you will have the flexibility to work from the comfort of your own home. You will be required to work Monday through Friday, 8 am to 5 pm Arizona time, with occasional in-person office gatherings. You will have access to our state-of-the-art technology and tools, as well as a supportive team of colleagues who are dedicated to providing high-quality care to our clients.

• *Compensation and Benefits**

• Competitive hourly rate of $24-$34 per hour
• Comprehensive benefits package, including medical, dental, and vision insurance
• 401(k) retirement plan with company match
• Paid time off and holidays
• Opportunities for professional growth and development

• *About the Industry**

The healthcare industry is a rapidly evolving field, with new technologies and treatments emerging all the time. As a Prior Authorization Clinical Reviewer, you will have the opportunity to stay up-to-date on the latest developments in the field and to contribute to the development of new treatments and services.

• *USA Job Market Trends**

The job market in the United States is constantly evolving, with new trends and technologies emerging all the time. Some of the current trends in the job market include:

• Remote work and hybrid models
• Technology and digital skills
• Healthcare and biotechnology
• Renewable energy and sustainability
• E-commerce and logistics
• Cybersecurity
• Health and well-being
• Skilled trades and vocational roles
• Diversity, equity, and inclusion (DEI)
• Gig economy and freelancing
• Aging workforce and succession planning
• Reskilling and upskilling

• *How to Apply**

If you are a motivated and detail-oriented individual who is passionate about providing high-quality care to our clients, we encourage you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your qualifications and experience. We look forward to hearing from you!

• *Apply Now**