Prior Authorization RN

Job Summary

A company is looking for a Prior Authorization Registered Nurse 2.

Key Responsibilities:

• Review prior authorization requests for appropriate care and setting, approve services, or forward requests to appropriate stakeholders
• Complete medical necessity and level of care reviews using clinical judgment
• Educate providers on utilization and medical management processes

Required Qualifications:

• Licensed Registered Nurse (RN) in the state of Kentucky with no disciplinary action
• Minimum 3 years of experience as a nurse in a clinical setting
• Strong proficiency with MS Office Suite and ability to learn multiple systems
• Experience with the development and implementation of policies and procedures
• Bachelor's Degree preferred