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
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