Nurse Manager, Prior Authorization
San Francisco Health PlanHighlight
Summary
About the Role
About You
- Valid, unrestricted Registered Nurse (RN) or Nurse Practitioner (NP) license in the State of California.
- Bachelor's degree in Nursing or related field.
- Minimum of 4+ years of clinical experience in a healthcare setting.
- 2 to 4 years of supervisory or management experience.
- Experience in managed care, case management, resource management, or utilization review.
- Experience with Medi-Cal, Medicare, DHCS, DMHC, and NCQA regulations.
Benefits
- Health Benefits including medical, dental, and vision coverage.
- Employer-matched CalPERS Pension and 401(a) plans, 457 Plan.
- 23 days of Paid Time Off (PTO) and 13 paid holidays.
- Opportunities for tuition reimbursement and professional license/membership.
Created by the City and County of San Francisco, San Francisco Health Plan (SFHP) is the City's number one choice for Medi-Cal, providing the community with access to award-winning health care for the past 30 years. At SFHP, we are helping shape the future of health care with a focus on improving health outcomes in San Francisco's diverse and most vulnerable communities. Our creative, innovative, and mission-driven team works together to bring equitable access to health care for all San Franciscans. At SFHP, quality care comes first. We provide our members with a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning through the Medi-Cal and Healthy Workers HMO programs. Through strategic community collaborations, we also offer our members access to services beyond traditional health care to ensure their safety and well-being. SFHP's commitment to excellence has been recognized consistently by the state, with the Award for Excellence in Quality Care from the California Department of Health Care Services. In a continuous partnership with the San Francisco Department of Public Health, we are also the third-party administrator for Healthy San Francisco and the City Option Program. Join our winning team and learn about job opportunities on our website at sfhp.org/careers.