Delaware Licensed Clinical Review Nurse

Job is Expired
Location: Remote
Compensation: To Be Discussed
Reviewed: Tue, Oct 21, 2025

Job Summary

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
  • Provides recommendations to medical teams to promote quality and cost-effective care
  • Documents and maintains members' clinical information in health management systems for compliance
Required Qualifications
  • Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
  • 2-4 years of related experience preferred
  • Licensed Practical Nurse (LPN) - State Licensure required
  • RN license required for specific locations

COMPLETE JOB DESCRIPTION

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