Clinical Review Nurse - Louisiana
Company: VirtualVocations
Location: Mesquite
Posted on: November 16, 2024
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Job Description:
A company is looking for a Clinical Review Nurse - Prior
Authorization.
Key Responsibilities
Analyze prior authorization requests to determine medical necessity
and appropriate level of care
Coordinate with healthcare providers and interdepartmental teams to
ensure timely reviews and authorizations
Document and maintain member clinical information to ensure
compliance with regulatory guidelines
Required Qualifications, Training, and Education
Graduate from an Accredited School of Nursing or Bachelor's degree
in Nursing
2 - 4 years of related experience
RN/LPN/LVN Licensure in Louisiana or a Compact License required
Knowledge of Medicare and Medicaid regulations preferred
Understanding of utilization management processes preferred
Keywords: VirtualVocations, Plano , Clinical Review Nurse - Louisiana, Healthcare , Mesquite, Texas
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