Licensed Clinical Review Nurse
Company: VirtualVocations
Location: Huntington Beach
Posted on: November 7, 2024
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Job Description:
A company is looking for a Clinical Review Nurse - Prior
Authorization to analyze prior authorization requests for medical
necessity and appropriate levels of care.
Key Responsibilities
Perform medical necessity and clinical reviews of authorization
requests
Coordinate with healthcare providers and interdepartmental teams
for timely service reviews
Assist with service authorization requests for member transfers or
discharge plans
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
Keywords: VirtualVocations, Hacienda Heights , Licensed Clinical Review Nurse, Healthcare , Huntington Beach, California
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