Kentucky Licensed Prior Authorization Nurse

A company is looking for a Prior Authorization Registered Nurse. Key Responsibilities Review prior authorization requests for appropriate care and setting, approving services or forwarding requests as necessary Complete medical necessity and level of care reviews using clinical judgment and refer to stakeholders based on case findings Educate providers on utilization and medical management processes while maintaining clinical information in medical management systems Required Qualifications Licensed Registered Nurse (RN) in the state of Kentucky with no disciplinary action Minimum 3 years of experience as a nurse in a clinical setting Strong proficiency with MS Office Suite and ability to learn multiple systems Experience with the development and implementation of policies and procedures

Apr 9, 2025 - 23:22

A company is looking for a Prior Authorization Registered Nurse. Key Responsibilities Review prior authorization requests for appropriate care and setting, approving services or forwarding requests as necessary Complete medical necessity and level of care reviews using clinical judgment and refer to stakeholders based on case findings Educate providers on utilization and medical management processes while maintaining clinical information in medical management systems Required Qualifications Licensed Registered Nurse (RN) in the state of Kentucky with no disciplinary action Minimum 3 years of experience as a nurse in a clinical setting Strong proficiency with MS Office Suite and ability to learn multiple systems Experience with the development and implementation of policies and procedures