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Oregon 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 Collaborates with healthcare providers and authorization teams to ensure timely service reviews Maintains member clinical information in health management systems to ensure 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 preferred Knowledge of Medicare and Medicaid regulations preferred Knowledge of utilization management processes preferred LPN - Licensed Practical Nurse - State Licensure required
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
Collaborates with healthcare providers and authorization teams to ensure timely service reviews
Maintains member clinical information in health management systems to ensure 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 preferred
Knowledge of Medicare and Medicaid regulations preferred
Knowledge of utilization management processes preferred
LPN - Licensed Practical Nurse - State Licensure required
