Remote Pennsylvania Licensed Authorization Nurse

Job Summary

A healthcare company has a current position open for a Remote Pennsylvania Licensed Authorization Nurse.

Individual must be able to fulfill the following responsibilities:

• Serve as a liaison between care managers and payors and facilitates payor/physician contact when indicated
• Communicates to the Medical Directors, Attending Physicians and/or CFO
• Act as a resource to other departments as well as the care managers leveraging clinical expertise

Qualifications Include:

• RN
• Five years of acute care clinical experience, two years payer or care management experience
• Understanding of clinical and care management process
• Knowledge of medical necessity criteria
• Ability to apply InterQual criteria appropriately
• Prior utilization review experience