Indiana Licensed Secondary Review Nurse

Job Summary

Indiana Licensed Secondary Review Nurse evaluates clinical requests for Home and Community-Based Services (HCBS) in a full-time, salaried position, ensuring care is medically necessary and compliant with state regulations.

Key Responsibilities

• Participate in secondary reviews for HCBS and Medicaid services
• Review and process prior authorization requests for LTSS and HCBS services
• Collaborate with care managers and physicians to ensure continuity of care

Required Qualifications

• Current, unrestricted RN license in the state of Indiana
• 3+ years of clinical experience in hospital, acute care, home health/hospice, or case management
• 2+ years of experience with functional assessments for LTSS services
• 2+ years of experience with Medicaid, Medicare, or Managed Care
• Intermediate level of knowledge of LTSS eligibility and service allocation