Prior Authorization Technician Supervisor (Non-Clinical) Name * settings First Name Name * settings Last Name Name * settings Suffix Email * settings Phone number * settings Please upload your resume/CV settings Professional Category * settings Physician Clinical, Non-Physician Non-Clinical Staff Professional Designation (Check all that apply. If none, select N/A) * settings N/A MD PA NP LCSW RN LPN/LVN DO CNA MA State of Residence * settings - Choose - AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC TN TX UT VT VA WA WV WI WY License Type (Check all that apply. If none, select N/A) * settings N/A RN MD NP PA Boards & Certifications (Check all that apply. If none, select N/A) * settings N/A Advanced Practice Registered Nursing (APRN) Allergy and Immunology Ambulatory Care Nursing Anesthesiology Bariatric Nurse Business in Nursing Camp Nursing Cardiac Care Nursing Cardiac Cath Lab Nursing Case Management Nursing Clinical Nurse Leader Clinical Nurse Specialist Colon and Rectal Surgery Dermatology Emergency Medicine Family Medicine Family Nurse Practitioner Flight/Transport Nursing Forensic Nursing Gastroenterology Nursing Genetics Nursing Geriatric Nursing Gerontological Nurse Practitioner Gynecology/Obstetric Nursing Health Policy Nursing Hematology Nursing HIV/AIDS Nursing Holistic Nursing Home Health Care Nursing Hospice/Palliative Nursing Independent Nurse Contractor Infection Control Nursing Informatics Nursing Infusion Nursing International Nursing Labor and Delivery Nursing Lactation Consultation Legal Nurse Consultant Licensed Practical Nursing (LPN or LVN) Long-Term Care Nursing Managed Care Nursing Medical Genetics and Genomics Medical-Surgical Nursing Military and Uniformed Service Nursing Missionary Nursing Neonatal Intensive Care Nursing Nephrology Nursing Neurological Surgery Neurology Neuroscience Nursing Nuclear Medicine Nurse Anesthetist Nurse Attorney Nurse Educator Obstetrics and Gynecology Occupational Health Nurse Oncology Nursing (Cancer Nursing) Operating Room Nursing (Perioperative Nursing) Ophthalmic Nursing Ophthalmology Orthopaedic Surgery Orthopedic Nursing Otorhinolaryngology Nursing (Head and Neck Nursing) Overseas, Volunteer, Missionary, or Refugee Nursing Pain Management Nursing Parish Nursing Pathology Pediatrics Pediatric Endocrinology Nursing Pediatric Nurse Perianesthesia Nursing (Preanesthesia and Postanesthesia Nursing) Perinatal Nursing Physical Medicine and Rehabilitation Plastic Surgery Plastic Surgery Nursing Poison Information Specialist Population Health PowerPoint Preventive Medicine Psychiatry and Neurology Psychiatric Nurse Practitioner Psychiatric Nursing Public Health Nurse Pulmonary Care Nursing (Respiratory Nursing) Radiology Radiology Nursing Sexual Assault Nurse Examiner School Nursing Social Determinants of Health Substance Abuse Nursing Surgery (General Surgery) Surgical Nursing Synergy Tapestry Telemetry Nursing Telephone Triage Nursing Thoracic Surgery Toxicology Nursing Transcultural Nursing Transplant Nursing Trauma Nursing Travel Nursing Triage Nursing TruCare Urologic Nursing Urology URAC Utilization Management (UM) Women's Health Women's Health Nursing Do you have an active, current multistate license? * settings N/A Yes No For which state is your multistate license issued? (If none, select N/A) * settings - Choose - N/A AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC TN TX UT VT VA WA WV WI WY Current State(s) of Licensure (Check all that apply. If none, select N/A) * settings N/A AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC TN TX UT VT VA WA WV WI WY Do you have health plan experience? * settings Yes No If yes, how many years of health plan experience? settings Indicate experience with the following: (Check all that apply. If none, select N/A) * settings N/A Beacon Care Management CareRadius CaseTrakker CMS Community Based Care Conduent DST Epic eCare eQ Health Excel Facets FQHC GuidingCare Google Workspace Health Equity HealthRules Helios InfoMC Jiva MCK Medicaid Medecision MHK OICS Outlook Outlook Calendar Pega PAHub PowerPoint QMEIS Social Determinants of Health Substance Use Disorders Synergy Tapestry TruCare Change Healthcare Areas of Expertise (Check all that apply. If none, select N/A) * settings N/A Appeals Audit Care Management (CM) Coding Crisis Calls Compliance Intake/Administration LTSS Medical Director NCQA Peer Review Services (PRS) Quality Management (QM) URAC UM - Utilization Management Submit Prior Authorization Technician Supervisor (Non-Clinical) Click Submit to finish. arrow_back Back Submit
