California Licensed Prior Authorization Nurse

A company is looking for a UM Prior Authorization Nurse, LVN/LPN. Key Responsibilities Evaluate and process prior authorization requests based on clinical guidelines Act as a liaison between healthcare providers, patients, and health plans Accurately document all authorization activities and ensure compliance with regulations Required Qualifications Associate's degree in Nursing, preferred Minimum 2 years of experience in medical management clinical functions Active and Unrestricted License as an LVN or LPN for the State of California Working knowledge of MCG, InterQual, and NCQA standards Certification in Managed Care Nursing (CMCN) preferred

Apr 25, 2025 - 00:29
 0
California Licensed Prior Authorization Nurse
A company is looking for a UM Prior Authorization Nurse, LVN/LPN. Key Responsibilities Evaluate and process prior authorization requests based on clinical guidelines Act as a liaison between healthcare providers, patients, and health plans Accurately document all authorization activities and ensure compliance with regulations Required Qualifications Associate's degree in Nursing, preferred Minimum 2 years of experience in medical management clinical functions Active and Unrestricted License as an LVN or LPN for the State of California Working knowledge of MCG, InterQual, and NCQA standards Certification in Managed Care Nursing (CMCN) preferred