A company is looking for a UM Post-Acute SNF RN.
Key Responsibilities
Review medical records for post-acute prior authorization requests for medical necessity
Manage prior authorizations from initial review to discharge, ensuring compliance with CMS requirements
Coordinate discharge planning and collaborate with facility staff for timely discharges
Required Qualifications
Current and valid Compact Registered Nurse (RN) license
At least 2 years of experience in a post-acute or hospital setting
Minimum of 1 year of experience performing medical necessity reviews using CMS criteria
Strong knowledge of CMS guidelines and NCD / LCD policies
Experience working remotely is preferred
Care • Oceanside, California, United States