Prior Authorization Nurse Reviewer

Job Summary

A company is looking for a Prior Authorization Nurse Reviewer.

Key Responsibilities:

• Perform prior authorization reviews of admissions, procedures, services, and supplies
• Document decisions and rationale while maintaining clinical information
• Assist in training new Utilization Review Nurses and stay updated on clinical criteria guidelines

Required Qualifications:

• Active and unrestricted United States nursing license (LPN, LVN, or RN)
• 5+ years of clinical or in-facility experience
• 1+ year of utilization review experience
• Preferably an Alaskan resident or located in the USA
• Experience in InterQual or Milliman criteria is beneficial