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Posted: 10/21/2026Part Time Prior Authorizations Nurse, RN – Temporary
Central California Alliance for HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Utilization Management and prior authorization processes, with a strong foundation in clinical nursing principles and practices. Proficient in evaluating medical records and applying relevant regulations and guidelines within managed care settings.
Highest-signal resume keywords
Registered Nurse License - CaliforniaUtilization Management ExperienceKnowledge of Prior Authorization PrinciplesWorking Knowledge of Medicare D-SNPMCG Guidelines Familiarity
About the role
Key responsibilities & impact- Ensure prior authorization requests meet contractual requirements
- Conduct prior authorization reviews using nationally recognized and evidence-based standards
- Participate in Utilization Management Care Programs
- Report to the Utilization Management Supervisor
- Work a temporary assignment estimated through the end of December 2026, subject to business need
- Work 20 to 40 hours per week, Monday through Friday
- Support Central California Alliance for Health, a regional Medi-Cal managed care plan providing health insurance to members
- Attend quarterly company-wide events or department meetings as expected
- In-office or in-community presence may be required depending on business need
Requirements
What you’ll need- Current unrestricted license as a Registered Nurse issued by the State of California
- Associate’s degree in Nursing and a minimum of five years of experience in a patient care setting, including a minimum of one year of experience in Utilization Management or Case Management
- A Bachelor’s degree may substitute for two years of the required experience
- An equivalent combination of education and experience may be qualifying
- Working knowledge of managed care, Medicare D-SNP, Medi-Cal programs, related regulations, CMS guidelines, Local Coverage Determinations, and National Coverage Determinations
- Working knowledge of Microsoft Excel, PowerPoint, and database software
- Knowledge of prior authorization principles and practices
- Knowledge of clinical nursing principles and practices
- Knowledge of MCG Guidelines, Medi-Cal regulations, and Title 22 regulations
- Ability to evaluate medical records and other health care data
- Ability to interpret, apply, and explain policies, regulations, terms, and procedures
- Ability to maintain organized and accurate records
- Must be currently authorized to work in the United States on a full-time, ongoing basis without current or future employer sponsorship
- Bachelor’s degree in Nursing listed as a desirable qualification
Benefits
Comp & perks- Medical, Dental and Vision Plans
- Ample Paid Time Off
- 12 Paid Holidays per year
- 401(a) Retirement Plan
- 457 Deferred Compensation Plan
- Robust Health and Wellness Program
- Onsite EV Charging Stations
- Temporary employees are connected to a staffing agency with separate benefit options
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical Nursing PrinciplesPrior Authorization PracticesMedical Record EvaluationOrganized Record MaintenanceEvidence-Based Standards Application
Soft Skills
Ability to Interpret PoliciesEffective Communication SkillsOrganizational Skills
Tools & Technologies
Microsoft ExcelMicrosoft PowerPointDatabase Software
Certifications & Qualifications
Registered Nurse License
Industry Keywords
Utilization ManagementMedi-Cal ProgramsCMS GuidelinesLocal Coverage DeterminationsNational Coverage DeterminationsTitle 22 Regulations