New Jersey Licensed RN - Prior Authorizations

Job Summary

A company is looking for an RN I- Prior Authorizations Medicaid/DSNP.

Key Responsibilities

• Assess patients' clinical needs against established guidelines to ensure appropriate care levels
• Coordinate and implement care plans for members, monitoring services and negotiating fees as necessary
• Document care activities accurately and advocate for members among various healthcare providers

Required Qualifications

• High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree
• Minimum of two (2) years clinical experience required
• Active Unrestricted NJ RN License or active Compact License required
• Proficiency in personal computers and supporting software in a Windows environment preferred
• Working knowledge of case/care management principles and utilization management preferred