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Job Summary
This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care.
JOB REQUIREMENTS :
- LPN with valid, current, unrestricted clinical license in the state of operations.
- 3 years of clinical experience in physician office, hospital, or surgical setting.
- Customer service oriented to assist internal / external customers.
- Verbal and written communication skills.
- Interpersonal skills and ability to be a team player.
- Willingness and ability to travel.
- Familiar with PC or database systems.
- Incumbents with nursing licenses in positions / departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management.
Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.
PREFERRED JOB REQUIREMENTS :
- Utilization review or utilization management experience
- 3 years Med / Surg experience is a plus
LI-Remote
INAK
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HCSC Employment Statement :
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$43,900.00 - $97,700.00
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