**About arenaflex:**
arenaflex is a leading healthcare organization that has been serving Arizonans since 1985. We provide access to physical and social healthcare services to individuals who are eligible for Medicaid. Our team is dedicated to integrating families, children, seniors, and individuals with developmental or mental disabilities. We have various agreements with AHCCCS, Arizona's Medicaid office, and pass organizations generally throughout the state.
**About the Role:**
We are seeking an experienced Full Stack Data Entry Specialist to join our team at arenaflex. As a Full Stack Data Entry Specialist, you will be responsible for prior authorization review of physical and social healthcare-related services. You will utilize your clinical skills to arrange, record, and disburse all aspects of the use/benefit management program. You will also use your critical thinking and data analysis skills to determine clinically appropriate treatment, evidence-based care, and clinical need models for the use of services for individuals with disabilities and special healthcare needs.
**Key Responsibilities:**
* Prior authorization review of physical and social healthcare-related services
* Utilization of clinical skills to arrange, record, and disburse all aspects of the use/benefit management program
* Use of critical thinking and data analysis skills to determine clinically appropriate treatment, evidence-based care, and clinical need models for the use of services for individuals with disabilities and special healthcare needs
* Accepting provider calls associated with prior authorization questions and making decisions for individuals to advise regarding care confirmation
* Gathering clinical information and applying appropriate clinical need guidelines/rules, techniques, framework, and clinical judgment to convey care affirmation/idea/discharge orchestrating along the continuum of care
* Use of clinical experience and skills in a helpful cycle to review and work with legitimate clinical care organizations/benefits for individuals
* Recognizing confirmation of individuals who could benefit from care management activities and support of the reference
* Recognizing confirmation of opportunities to promote quality adequacy of clinical care organizations and benefit utilization
**Requirements:**
* 5+ years of clinical experience as an RN
* Active and unrestricted RN licensure in the state of Arizona
* Must be willing and able to participate in in-state meetings occasionally
* Reliable transportation is required; mileage is reimbursed per our organization's cost reimbursement system
**Preferred Qualifications:**
* Prior utilization management experience
* Strong critical thinking and analytical skills
* Long-term experience in Nursing is required
**USA Job Market Trends:**
The COVID-19 pandemic has caused a significant growth in remote work and flexible work arrangements. Many employers and employees have embraced remote and hybrid work models, which will affect how jobs are established in the future. Some of the key trends affecting the job market in the United States include:
* Technology and Digital Skills: The demand for technology-associated skills, including coding, data analysis, and virtual marketing, has been continuously high. Technology-driven roles have been on the rise across various industries.
* Healthcare and Biotechnology: The pandemic has highlighted the importance of the healthcare sector, particularly due to the persistent growth in roles associated with healthcare, pharmaceuticals, biotechnology, and clinical research.
* Renewable Energy and Sustainability: There has been growing interest in renewable energy sources and sustainability practices, leading to growth in areas like clean energy, environmental conservation, and green technology.
* E-Commerce and Logistics: The shift toward online purchasing has driven a demand for jobs in e-commerce platforms, delivery chain management, and last-mile logistics.
* Cybersecurity: With the growing reliance on virtual infrastructure, cybersecurity has become a critical concern, leading to a growing demand for expert professionals in cybersecurity and data protection.
* Health and Well-being: Companies have been focusing more on employee well-being, particularly to address the demand for roles associated with mental health support, wellness programs, and work-life balance initiatives.
* Skilled Trades and Vocational Roles: Skilled trades, including electricians, plumbers, and mechanics, have seen a shortage of workers, providing opportunities for individuals interested in vocational careers.
* Diversity, Equity, and Inclusion (DEI): Organizations are placing more emphasis on developing diverse and inclusive work environments, particularly due to the emergence of roles targeted at DEI initiatives.
* Gig Economy and Freelancing: The gig economy continues to grow, providing opportunities for individuals to work as freelancers, consultants, and independent contractors in various industries.
* Aging Workforce and Succession Planning: The aging population has triggered discussions about workforce planning and skills succession techniques in industries with a large percentage of older workers.
* Reskilling and Upskilling: Lifelong learning and continuous skill development have become critical as industries evolve rapidly. Many individuals are seeking opportunities to reskill or upskill to remain competitive in the job market.
**Why Join arenaflex?**
* Competitive salary and benefits package
* Opportunity to work from home with flexible hours
* Collaborative and supportive team environment
* Professional development and growth opportunities
* Recognition and rewards for outstanding performance
**How to Apply:**
If you are a motivated and experienced Full Stack Data Entry Specialist looking for a new challenge, we encourage you to apply to this exciting opportunity. Even if you feel you're not a perfect match, we'd still love to hear from you. We are looking for great people to join our friendly team.