Clinical Review Nurse - NY Licensed

VirtualVocations
Coral Gables, Florida, United States
Full-time

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 for timely review of services and requestsAssist with service authorization requests for member transfers or dischargesRequired Qualifications, Training, and EducationGraduate from an Accredited School of Nursing or Bachelor's degree in Nursing2 - 4 years of related experienceActive New York State clinical license (LPN or RN)Knowledge of Medicare and Medicaid regulations preferredKnowledge of utilization management processes preferred

2 days ago
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