Title - Clinical Review Nurse Prior Authorization
Duration - 12 months
Shift - M/Th-Sat 7am-6pm or W-Sat 7am-6pm (Saturday a must)
Location - MST time would be preferred, but anywhere in the US other than California or New York is okay with an active LVN/LVN or RN license
Pay rate: $38-40.00/hr
Overview
Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.
Responsibilities
License/Certification:
Education/Experience:
Preferred Experience
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