Compact Licensed RN Prior Authorization Nurse

A company is looking for an RN Prior Authorization Nurse with a Healthcare Compact License. Key Responsibilities Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews Determines medical necessity of requests by applying medical criteria and guidelines Documents and communicates all utilization review activities and outcomes Required Qualifications Current, unrestricted Texas RN license or compact license 2+ years of experience in managed care or 5+ years of nursing experience Proficient in PC software skills

Jun 17, 2025 - 10:50

A company is looking for an RN Prior Authorization Nurse with a Healthcare Compact License. Key Responsibilities Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews Determines medical necessity of requests by applying medical criteria and guidelines Documents and communicates all utilization review activities and outcomes Required Qualifications Current, unrestricted Texas RN license or compact license 2+ years of experience in managed care or 5+ years of nursing experience Proficient in PC software skills