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New York RN Clinical Review Nurse
A company is looking for an RN Clinical Review Nurse - Prior Authorization. Key Responsibilities Analyze prior authorization requests to determine medical necessity and appropriate level of care Coordinate with healthcare providers to ensure timely reviews of services and requests Document and maintain member's clinical information in health management systems for compliance Required Qualifications, Training, and Education Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing 2 - 4 years of related experience Licensed Practical Nurse (LPN) State Licensure required Clinical knowledge and ability to analyze authorization requests preferred Knowledge of Medicare and Medicaid regulations preferred
A company is looking for an RN Clinical Review Nurse - Prior Authorization.
Key Responsibilities
Analyze prior authorization requests to determine medical necessity and appropriate level of care
Coordinate with healthcare providers to ensure timely reviews of services and requests
Document and maintain member's clinical information in health management systems for compliance
Required Qualifications, Training, and Education
Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
2 - 4 years of related experience
Licensed Practical Nurse (LPN) State Licensure required
Clinical knowledge and ability to analyze authorization requests preferred
Knowledge of Medicare and Medicaid regulations preferred