Prior Authorization Rn Jobs in Virginia (NOW HIRING)

Join CHoR's growing, nationally recognized Pediatric Urology program as an Ambulatory Divisional Registered Nurse (RN) and play a key role in delivering high-quality, patient-centered care.
In this collaborative, team-based environment, you will partner with physicians and advanced practice providers to care for pediatric patients with a wide range of urologic conditions-from common to complex, including undescended testes, hypospadias, UTIs, hydronephrosis, and neurogenic bladder.
This role offers the opportunity to provide hands-on clinical care, lead patient and family education, coordinate care across settings, and participate in specialty procedures such as uroflow testing and urodynamics.
The ideal candidate is a clinically strong, team-oriented nurse who is passionate about delivering exceptional care and contributing to a dynamic and specialty-focused ambulatory program.
The Ambulatory Divisional Registered Nurse provides, develops, coordinates, and manages clinical duties related to the specific service line division. This job will support clinical care across multiple outpatient locations, requiring interdisciplinary partnership with multiple providers within the division. The position collaborates with Ambulatory Leadership, Division Chair, Medical Director, in the development and management of processes to provide safe, timely ambulatory care needs.
The Ambulatory Divisional Registered Nurse will have a working knowledge of outpatient management of patients within a specialty division, including general medical, complex medical, pre-operative and post-operative care.

Essential Job Statements

Follows documented physician/licensed provider orders, within the boundaries of the Nurse Practice Act, licensure, and established standards, policies, and practice guidelines.

Triages patient calls and in basket messages in accordance with ambulatory and division specific standards.

Facilitates training as needed to improve the specialty knowledge base across all ambulatory clinic locations.

Partners with care team to complete chart prep for return visits; reviews records (lab work, imaging, diagnostic reports) prior to patient visit.

Completes necessary new patient referrals, ensures outside records are available, performs chart review/prep to ensure patients are scheduled into the correct clinic.

Provides disease and procedure-specific education to patients in clinic.

Creates educational materials to support commonly encountered topics within division.

May assist providers during clinical procedures across the division.

Partners with providers, Assistant Clinical Manager, Program Coordinators, and Nurse Navigators to ensure continuity of care across clinic sites for division patients with expertise in service, preoperative, postoperative, and medical management to specific patient populations.

Performs multi-site nursing visits as directed by providers to include education, treatments, or assessments.

Supports prior authorization requirements specific to emergent / same day prior authorizations and denial appeals.

Partners with Assistant Clinical Manager and clinic nursing staff to aid providers in obtaining clinic testing and treatment.

Consistently monitors patient satisfaction and customer feedback, taking prompt action on issues striving for service excellence.

Serves as a nursing clinical role model and division subject matter expert for management of ambulatory patients across multiple sites.

Seeks collaborative relationships that can lead to effective partnerships in research, evidence based practice or process improvement. Contributes to revising and developing clinical practice and/or nursing care guidelines for specific patient populations using current best evidence and shares the synthesis of current best evidence at the department/division level.

Takes appropriate actions to enhance positive outcomes, even in the most challenging situations.

Anticipates needs to provide quality and efficient care for patients.

Maintains professional growth and development in specialty through ongoing process of formal and informal education and training.

Performs other duties as assigned and/or participates in special projects in order to support the mission of VCUHS and the division.

Accepts alternate assignments as required.

Patient Population: Demonstrates the knowledge and skills necessary to provide equitable care appropriate to the age of the patients served on their assigned unit.Demonstrates knowledge and related competencies of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to their age, specific needs and to provide the equitable care needed as described in departmental policies and procedures. Neonates (0-4 weeks), Infant (1-12 months), Pediatrics (1-12 years), Adolescents (13-17 years), Adults (18-64 years), Geriatrics (65 years and older)

Employment Qualifications

Required Education: Bachelor's degree in nursing from an accredited program

Preferred Education: Master's degree in nursing from an accredited program.

Licensing/ Certification

Licensure/Certification Required: Current Registered Nurse license, BLS Certification.

Licensure/Certification Preferred: Nursing specialty board certification preferred.

Minimum Qualifications

Years and Type of Required Experience: Minimum 3 years of nursing experience required. 1-2 years preferred experience in the designated pediatric or adult division.

Other Knowledge, Skills and Abilities Required: Strong communication and time management skills. Ability to set priorities, make timely decisions, and meet multiple deadlines.

Ability to work collaboratively within a large complex, fast-paced environment.

Other Knowledge, Skills and Abilities Preferred: N/A

Working Conditions: Periods of high stress and fluctuating workloads may occur. General office environment. May be exposed to physical altercations and verbal abuse. Required to car travel to off-site locations, occasionally in adverse weather conditions. Other: Travel between clinic sites is required. Long-distance or air travel as needed- not to exceed 10% travel. May be exposed to high noise levels. May be exposed to limited hazardous substances or body fluids. * May be exposed to human blood and other potentially infectious materials. * May have periods of constant interruptions. Prolonged periods of working alone.

* Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

Physical Requirements

Physical Demands: Lifting/ Carrying (0-50 lbs.), Push/ Pull (50-100 lbs.), Stoop, Kneel, Squat, Climbing, Balance, Bending

Work Position: Sitting, Walking, Standing

Additional Physical Requirements/ Hazards

Physical Requirements: Manual dexterity (eye/hand coordination), Hear alarms/telephone/tape recorder, Reach above shoulder, Repetitive arm/hand movements, Finger Dexterity, Color Vision

Hazards: Depth perception, Exposure to toxic/caustic/chemicals/detergents, Exposure to moving mechanical parts, Exposure to dust/fumes

Mental/Sensory -Emotional

Mental / Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Write Legibly, Reading, Logical Thinking

Emotional: Fast pace environment, Steady Pace, Able to Handle Multiple Priorities, Frequent and Intense Customer Interactions, Noisy Environment, Able to Adapt to Frequent Change

Compensation Range

$35.16 - $58.05

Actual salary offers will be based on several key factors to include relevant work experience, credentials, and qualifications.

EEO Employer/Disabled/Protected Veteran