Pre-Authorization Nurse Florida
Company: VirtualVocations
Location: Fullerton
Posted on: November 16, 2024
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Job Description:
A company is looking for a Pre-Authorization Nurse to review
prior authorization requests for appropriate care and settings.
Key Responsibilities
Conduct medical necessity and level of care reviews using clinical
judgment
Refer cases to internal stakeholders and educate providers on
utilization and medical management processes
Maintain clinical information in medical management systems and
communicate with providers or members
Required Qualifications
Licensed Registered Nurse (RN) in Florida or a compact state with
no disciplinary action
2 or more years of Utilization Management (UM), Pre-Auth, or
managed care review experience
1 or more years of acute and/or critical care clinical
experience
Proficient with MS Office Word, Excel, and Outlook
Availability to work Tuesday - Saturday, 8am-5pm EST, with
potential overtime and holidays
Keywords: VirtualVocations, Moreno Valley , Pre-Authorization Nurse Florida, Healthcare , Fullerton, California
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