REGISTERED NURSE
2 weeks ago
As a Prior Authorization Nurse, you work outside the walls of a hospital setting in a specialty area of the nursing field providing utilization management prior authorization reviews.
Build strong direct relationships with providers and medical directors through review of member clinical information, applying criteria, and completing authorization determinations in accordance with company policies and procedures, Document patient care activity and communication with the, provider and medical director. Participate in on call rotation as indicated by staffing and business needs.
Duties:
- Registered Nurse with current license in LA state of employment. Additional licensure may be required in multi-state service areas.
- Minimum 3 years nursing experience with a minimum of 1 year in utilization management/ prior authorization review experience.
Experience:
Utilization Management. Prior Authorization Review experience
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