Licensed Clinical Review Nurse

VirtualVocations
Durham, North Carolina, United States
Full-time
We are sorry. The job offer you are looking for is no longer available.

A company is looking for a Clinical Review Nurse - Prior Authorization to analyze prior authorization requests for medical necessity and appropriate levels of care.

Key ResponsibilitiesPerform medical necessity and clinical reviews of authorization requestsCoordinate with healthcare providers and interdepartmental teams for timely service reviewsAssist with service authorization requests for member transfers or discharge plansRequired Qualifications, Training, and EducationGraduate from an Accredited School of Nursing or Bachelor's degree in Nursing2 - 4 years of related experienceLicensed Practical Nurse (LPN) State Licensure requiredClinical knowledge and ability to analyze authorization requests preferredKnowledge of Medicare and Medicaid regulations preferred

7 days ago
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