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California Licensed Clinical Review RN
A company is looking for a Senior Clinical Review RN - Prior Authorization. Key Responsibilities Reviews prior authorization requests to determine medical necessity and appropriate level of care Collaborates with healthcare providers to ensure timely review and authorization of services Manages service authorization requests related to member transfers or discharges Required Qualifications Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing 4 - 6 years of related experience RN license required for California Advanced clinical knowledge preferred Strong knowledge of Medicare and Medicaid regulations preferred
A company is looking for a Senior Clinical Review RN - Prior Authorization.
Key Responsibilities
Reviews prior authorization requests to determine medical necessity and appropriate level of care
Collaborates with healthcare providers to ensure timely review and authorization of services
Manages service authorization requests related to member transfers or discharges
Required Qualifications
Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
4 - 6 years of related experience
RN license required for California
Advanced clinical knowledge preferred
Strong knowledge of Medicare and Medicaid regulations preferred
