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About the Role:
- Temporary full-time, estimated August-December 2026.
- Employed via staffing agency while working at the Alliance.
Key Responsibilities:
- Manage prior authorization and conduct clinical reviews.
- Use MCG Guidelines and CMS regulations to evaluate records.
- Support Utilization Management Care Programs.
Qualifications:
- Current unrestricted RN license in California.
- Associate's in Nursing and 5 years patient care, including 1 year in UM/Case Management.
- Knowledge of Medi-Cal, Medicare, and managed care preferred.
Central California Alliance for Health
Central California Alliance for Health is a regional non-profit health plan providing accessible, quality health care guided by local innovation to members in five California counties. The organization employs over 500 dedicated employees in a respectful, diverse, professional, and fun culture.