Illinois Licensed Clinical Review Nurse
A company is looking for a Clinical Review Nurse - Prior Authorization. Key Responsibilities Analyzes prior authorization requests to determine medical necessity and appropriate level of care Coordinates with healthcare providers and internal teams to ensure timely reviews and authorizations Documents and maintains clinical information in health management systems for compliance with regulations Required Qualifications Active, current Illinois LPN or RN licensure Graduate from an accredited school of nursing or Bachelor's degree in Nursing 2 - 4 years of related experience preferred Knowledge of Medicare and Medicaid regulations preferred Understanding of utilization management processes preferred
A company is looking for a Clinical Review Nurse - Prior Authorization.
Key Responsibilities
Analyzes prior authorization requests to determine medical necessity and appropriate level of care
Coordinates with healthcare providers and internal teams to ensure timely reviews and authorizations
Documents and maintains clinical information in health management systems for compliance with regulations
Required Qualifications
Active, current Illinois LPN or RN licensure
Graduate from an accredited school of nursing or Bachelor's degree in Nursing
2 - 4 years of related experience preferred
Knowledge of Medicare and Medicaid regulations preferred
Understanding of utilization management processes preferred
