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NJ Licensed Prior Authorization RN
A company is looking for a Prior Authorization Registered Nurse (RN). Key Responsibilities Evaluate clinical needs against guidelines to determine medical necessity for services and procedures Develop and implement patient care plans to facilitate care transitions and service delivery Monitor care to ensure adherence to clinical guidelines and participate in quality improvement initiatives Qualifications Active NJ or Compact RN license Reside in NJ, PA, NY, DE, or CT Minimum of 3 years of clinical RN experience At least 2 years of experience in a Health Plan within Prior Authorization or Utilization Review Proficiency in Microsoft Office Suite and understanding of hospital structures and payment systems
A company is looking for a Prior Authorization Registered Nurse (RN).
Key Responsibilities
Evaluate clinical needs against guidelines to determine medical necessity for services and procedures
Develop and implement patient care plans to facilitate care transitions and service delivery
Monitor care to ensure adherence to clinical guidelines and participate in quality improvement initiatives
Qualifications
Active NJ or Compact RN license
Reside in NJ, PA, NY, DE, or CT
Minimum of 3 years of clinical RN experience
At least 2 years of experience in a Health Plan within Prior Authorization or Utilization Review
Proficiency in Microsoft Office Suite and understanding of hospital structures and payment systems
