Multi-State Licensed Clinical Review Nurse

A company is looking for a Clinical Review Nurse - Prior Authorization - LVN/LPN. Key Responsibilities Analyzes prior authorization requests to determine medical necessity and appropriate level of care Coordinates with healthcare providers and teams to ensure timely review and authorization of services Documents and maintains member clinical information in compliance with regulatory guidelines Required Qualifications Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing 2 - 4 years of related experience LPN - Licensed Practical Nurse - State Licensure required Clinical knowledge in analyzing authorization requests preferred Knowledge of Medicare and Medicaid regulations preferred

Apr 7, 2025 - 20:10

A company is looking for a Clinical Review Nurse - Prior Authorization - LVN/LPN. Key Responsibilities Analyzes prior authorization requests to determine medical necessity and appropriate level of care Coordinates with healthcare providers and teams to ensure timely review and authorization of services Documents and maintains member clinical information in compliance with regulatory guidelines Required Qualifications Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing 2 - 4 years of related experience LPN - Licensed Practical Nurse - State Licensure required Clinical knowledge in analyzing authorization requests preferred Knowledge of Medicare and Medicaid regulations preferred